Evans v. Fenty ( 2010 )


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  •                             UNITED STATES DISTRICT COURT
    FOR THE DISTRICT OF COLUMBIA
    ____________________________________
    )
    JOY EVANS, et al.,                       )
    )
    Plaintiffs,           )
    )
    UNITED STATES OF AMERICA,                )
    )
    Plaintiff-Intervenor, )            Civil Action No. 76-0293 (ESH)
    )
    v.                           )
    )
    ADRIAN FENTY, et al.,                    )
    )
    Defendants.           )
    ____________________________________)
    MEMORANDUM OPINION
    In 1976, residents of Forest Haven, then the District of Columbia’s institution for persons
    with developmental disabilities, filed this class action alleging that they were receiving
    constitutionally-deficient care, treatment, education, and training. In 1978, the Court entered a
    consent decree pursuant to which defendants agreed that plaintiffs’ constitutional rights had been
    violated and that they would take certain actions to remedy those violations.1 A series of consent
    orders and remedial plans followed in which defendants admitted that they were still violating
    class members’ constitutional rights and agreed to take additional actions to remedy those
    constitutional violations. The last such consent order and remedial plan was entered into in
    1
    Plaintiffs are a class of former residents of Forest Haven. As of December 2009, there
    were 600 class members (see Court Monitor Report at 2, Dec. 10, 2009); the original class has
    decreased due to the deaths of class members. The sole remaining defendants are the District of
    Columbia (“the District”) and the Mayor Adrian Fenty (collectively “the District” or
    “defendants”). The United States is also a party, having been permitted to intervene as a plaintiff
    in January 1977.
    2001, when the parties jointly agreed to a Plan for Compliance, pursuant to which defendants
    could demonstrate compliance with the Court’s orders and terminate the litigation.
    In 2006, plaintiffs filed a motion to find defendants in noncompliance and to appoint a
    receiver. On March 30, 2007, the Court granted that motion in part, concluding, based on
    extensive factual findings, that there had been “systemic, continuous, and serious noncompliance
    with many of the Court’s Orders.” Evans v. Fenty, 
    480 F. Supp. 2d 280
    , 325 (D.D.C. 2007)
    (“March 2007 Liability Opinion”). With respect to remedy, the Court asked the Special Masters
    to assist by making findings and recommendations to the Court that address, inter alia, “the
    current status of defendants’ compliance, what are the available options for curing the identified
    deficiencies, and whether a receivership is the most effective and efficient remedy available to
    the Court.” 
    Id. at 326
    .
    Now before the Court is the Special Masters’ Report and Recommendation, which
    concludes that, as of December 2008, defendants were still in noncompliance with the Court’s
    orders and recommends the appointment of an “Independent Compliance Administrator” to bring
    defendants into compliance and to end to this litigation. (Special Masters’ Report and
    Recommendation Regarding A Remedy For Defendants’ Noncompliance With Court Orders at
    128, Aug. 14, 2009 [“2009 Special Masters’ Report”].) Defendants have filed limited objections
    to the report and oppose the imposition of the proposed remedy;2 plaintiffs have no objections to
    2
    However, on March 29, 2010 – only a matter of days before the issuance of this
    Memorandum Opinion – defendants, having rebuffed all recent efforts to settle this matter and
    having resisted offering any alternatives to the Special Masters’ proposed remedies unless the
    remedy promised the swift cessation of Court supervision, filed a proposed alternate remedy for
    ending this litigation. (See Defs.’ Mot. for Consideration of Alternative to Appointment of
    Independent Compliance Administrator and for Entry of Exit Plan, March 29, 2010 [“Defs.’
    Mot. for Alternate Remedy”].) Obviously, there has been insufficient time for plaintiffs to
    2
    the report and ask that the Court adopt the findings of the Special Masters and their
    recommended remedy. Also before the Court is a motion the District filed, after the Special
    Masters concluded their proceedings in January 2009, to vacate all consent orders and to dismiss
    the entire case. For the reasons stated herein, defendants’ motion to vacate and dismiss will be
    denied. The Court will address, in a future memorandum opinion and order, defendants’
    objections to the Special Masters’ Report and Recommendations.
    BACKGROUND
    The lengthy procedural history of this litigation prior to March 30, 2007, will not be
    repeated here, as it was fully summarized in the Memorandum Opinion filed on that date. See
    Evans, 
    480 F. Supp. 2d at 281
    . Certain events, however, are relevant to defendants’ pending
    motions and will be briefly noted below, followed by a more detailed summary of the facts and
    procedural history that post-date that decision.3
    I.     KEY EVENTS PRIOR TO THE MARCH 30, 2007 LIABILITY OPINION
    A.      1978 Final Judgment and Order
    On June 14, 1978, the Court4 entered a “Final Judgment and Order” providing for
    permanent injunctive relief. Evans v. Washington, 
    459 F. Supp. 483
     (D.D.C. 1978) (“1978
    respond to this proposal, which, if nothing else, as a matter of fairness, should have been
    submitted during the remedy phase of this litigation so that the parties, the Special Masters, and
    the Court could have had some chance to address defendants’ new 17-page plan, which, on its
    face, appears to dramatically depart from the definition of outcomes and measurement of success
    that were agreed to by the parties when they entered into the 2001 Plan.
    3
    Although the Court will address the Special Masters’ Report and Recommendation in a
    separate memorandum opinion and order, many of the relevant facts will be included here as
    they are also relevant to the pending motion.
    4
    The Honorable John H. Pratt presided over this case from its inception until his death in
    August 1995.
    3
    Consent Order”). The 1978 Consent Order was premised on the recognition, which was
    consented to by the parties, that plaintiffs had federal constitutional rights under the due process
    clause of the Fifth Amendment “to be kept free from harm” and “to receive habilitative care and
    treatment in the alternative least restrictive of individual liberty” and that “violations of [those]
    federal constitutional rights . . . have occurred.” 
    Id. at 484
    . To remedy those violations, the
    1978 Consent Order required defendants and their successors to take a number of specific
    actions, see 
    id. at 484-90
    , that, loosely classified, fell into three categories: health care, safety,
    and welfare/habilitation. Defendants “consented to the entry of [the 1978 Consent Order] so as
    to assure protection of the rights of plaintiffs.” 
    Id. at 484
    .
    B.      1981 Consent Order
    In 1981, plaintiffs and plaintiff-intervenor filed motions for contempt, based on
    defendants’ noncompliance with the 1978 Consent Order. Those motions led to the entry of a
    second Consent Order, which supplemented defendants’ obligations under the 1978 Consent
    Order with a list of agreed-upon “measures necessary to the implementation of this Court’s
    Order of June 14, 1978.” (Consent Order at 1, June 25, 1981 [“1981 Consent Order”].) The
    1981 Consent Order did not revisit the legal conclusions of the 1978 Consent Order nor did it
    “release defendants from their obligations” thereunder. (Id. at 10.) Rather, the parties came to
    an agreement that defendants needed to take additional measures to assure protection of
    plaintiffs’ constitutional rights. The agreed-upon measures supplemented defendants’
    obligations in each area addressed by the 1978 Consent Order – health, safety and
    welfare/habilitation. (Id. at 1-10.)
    
    4 C. 1982
     Supreme Court Decision (Youngberg v. Romeo)
    In 1982, the Supreme Court decided Youngberg v. Romeo, 
    457 U.S. 307
     (1982),
    addressing for the first time the constitutional rights of an individual who had been involuntarily
    committed to a state institution for the mentally retarded. As discussed infra, defendants’ motion
    to vacate is based in part on the Youngberg decision and defendants’ contention, made for the
    first time in the 28 years since Youngberg was decided, that Youngberg changed the law and
    established that the 1978 Consent Order rested on “extraconstitutional” rights.
    D.      1983 Consent Order
    In 1982, plaintiffs and plaintiff-intervenor again filed motions for contempt, which led to
    the entry of a third Consent Order. (Consent Order, Feb. 8, 1983 [“1983 Consent Order”]). The
    1983 Consent Order similarly did not revisit the legal conclusions of the 1978 Consent Order nor
    did it release defendants from their obligations under prior orders; it merely added to those
    obligations “to assist in the implementation of those orders.” (Id. at 14-15.) Again, the agreed-
    upon measures supplemented defendants’ obligations in each area addressed by the 1978
    Consent Order – health, safety and welfare/habilitation. (Id. at 2-14.)
    E.      1990 Contempt Order
    In 1989, plaintiffs and plaintiff-intervenor again filed motions for contempt. In 1990, the
    Court issued an Order holding the District in civil contempt based on its “consistent and
    continuing violation of the three Consent Orders [of 1978, 1981 and 1983].” Evans, 
    480 F. Supp. 2d at 284
     (quoting Order, Jan. 30, 1990 [“Jan. 1990 Contempt Order”].) After a sanctions
    hearing, the Court issued an Order that, inter alia, required defendants to complete the
    outplacement of the 233 plaintiffs remaining at Forest Haven by September 30, 1991. 
    Id.
     (citing
    5
    Order, Apr. 9, 1990 [“Apr. 1990 Contempt Order”]). By October 1991, all plaintiffs had been
    moved from Forest Haven and the institution was closed.
    F.     1995 Contempt Order, Appointment of Special Master, 1996 Remedial Plan
    In 1995, four years after the closure of Forest Haven, plaintiff and plaintiff-intervenor
    filed motions for contempt, for remedial sanctions and for appointment of a Special Master.
    After two hearings, the Court again found the District to be in contempt based on “clear and
    convincing evidence, including defendants’ conceded violations, that the District is not in
    compliance with the consent orders in this case . . . .” (Findings of Fact & Conclusions of Law
    at 7, Oct. 11, 1995 [“1995 Contempt Order”].) In its decision, the Court5 observed that as of
    1995, it had “entered numerous orders, including consent orders between the parties, to
    safeguard the rights of class members and ensure their adequate and appropriate habilitation.”
    (Id. at 1.) The Court further noted that “[d]efendants admit that the District has a continuing
    responsibility to provide the class members with habilitation in accordance with their needs” and
    “admit that they also are required to provide adequate medical care, psychological care, day
    programming, community residential placements and other support systems as set forth in the
    class members’ [individual habilitation plans].” (Id. at 5-6 (emphasis added).) The Court
    proceeded to find the District in contempt because it (1) was delinquent in ensuring timely
    payment of providers, in violation of the 1983 Consent Order; (2) permitted inadequate case
    manager ratios, in violation of the 1983 Consent Order; and (3) offered inadequate “community
    living arrangements” and “community-based day programs and services as are necessary to
    5
    The case was reassigned to the Honorable Stanley S. Harris upon Judge Pratt’s death in
    1995.
    6
    provide them with minimally adequate habilitation,” in violation of the 1978 Consent Order. (Id.
    at 7-8.)
    The Court further found that defendants’ “history of noncompliance, compounded by the
    complicated and factually elusive nature of the matters under consideration,” required the
    appointment of a “Special Master” pursuant to Federal Rule of Civil Procedure 53 to “evaluate
    and ensure defendants’ compliance with the Court’s Orders and Consent Decrees . . . and to
    recommend remedies for any deficiencies in defendants’ compliance with the Orders.” (Order of
    Reference at 2, Oct. 11, 1995 [“1995 Reference Order”].)6
    In August 1996, the Court, based on a Report and Recommendation from the Special
    Master, adopted a “Remedial Plan,” designed “to enable defendants to come into compliance
    with the terms of this Court’s multiple Consent Orders” and to establish the conditions by which
    defendants could purge their civil contempt. Evans v. Barry, No. 76-CV-293, 
    1996 WL 451054
    ,
    at *1-*2 (D.D.C. Aug. 2, 1996) (“1996 Order & Remedial Plan”). In adopting the Remedial
    Plan, the Court observed that
    [d]efendants have, for over two years, chronically and unapologetically violated
    the terms of nearly every aspect of this Court’s multiple Consent Orders.
    Defendants’ unrelenting contempt of this Court’s orders, and their seeming
    inability to bring themselves in compliance therewith, have created chaos for the
    care providers vested with day-to-day responsibility for the members of this
    plaintiff class. The plaintiffs comprising this class, as defendants well know, are
    ill-equipped to adjust to or defend against the city’s failure to assist their care
    providers in giving them the care and treatment they desperately need.
    Id. at *2. The Court also warned defendants that:
    the point has been reached beyond which this Court will not tolerate further and
    continuing incidences of contempt by defendants. Any further noncompliance
    6
    The Court appointed Margaret G. Farrell to serve as Special Master.
    7
    with this Court’s longstanding Consent Orders, and noncompliance with the
    Remedial Plan issued this date, must be expected by defendants to result in
    serious consequences.
    Id. The remedial plan concerned defendants’ obligations in each area addressed by the 1978
    Consent Order – health, safety and welfare/habilitation. Id. at *3-*8
    G.      1999 Sanctions Order
    In April 1997, less than a year after the Court adopted the 1996 Remedial Plan, plaintiffs
    moved for sanctions based on the District’s admitted failure to pay providers within 30 days, as
    required under that Plan. In February 1999, the Court granted the motion and imposed a $5
    million fine on defendants.7 Evans v. Williams, 
    35 F. Supp. 2d 88
     (D.D.C. 1999). As part of that
    decision, the Court modified the 1996 Remedial Plan to order the Special Master to work with
    the parties to “develop and recommend to the Court a plan for the conclusion of the [litigation]”
    and the termination of the Court’s jurisdiction in a manner that would ensure that plaintiffs’
    interests would continue to be protected. 
    Id. at 97
    . As envisioned by the Court, the plan would
    include “recommended findings of fact and conclusions of law regarding the following topics”:
    a. Goals. A summary and articulation of the goals of this lawsuit as reflected in
    the 1978 and 1983 Consent Orders, the 1996 Remedial Plan, and all other
    Court-ordered obligations (hereafter collectively “Court-ordered requirements”).
    b. Current compliance. An evaluation of existing programs to determine the
    extent of defendants’ compliance with requirements for the protection of the
    health and safety of the plaintiff class and their effectiveness in meeting the goals
    described in subparagraph a, including but not limited to the provision of
    necessary medical and other health services and the compliance of private
    vendors with District of Columbia licensing and payment requirements governing
    community residence facilities, intermediate care facilities, foster care, day
    7
    The imposition of $5 million in contempt fines was reversed by the D.C. Circuit on the
    ground that the fines amounted to a criminal sanction that could not be imposed without a
    criminal trial. Evans v. Williams, 
    206 F.3d 1292
     (D.C. Cir. 2000).
    8
    treatment programs, day programs, employment programs, representative
    payment and guardianship.
    c. Adequate habilitation. The extent of defendants’ compliance with
    Court-ordered requirements for the provision of adequate habilitation in the least
    restrictive setting and their effectiveness (strengths and weaknesses) in meeting
    the goals described in subparagraph a, including individual habilitation planning,
    individual financial planning, case management, appropriate residential services,
    adequate habilitation services, and the safeguarding of client funds.
    d. Payment of providers. The extent of defendants’ compliance with
    Court-ordered requirements for the timely payment of private providers who
    provide the plaintiff class with appropriate residential services, day treatment
    programs, vocational and supported employment services, day programs, medical,
    mental health, dental, and other services required by the Court.
    e. Quality assurance. The quality assurance methods to be developed and
    implemented by defendants to monitor continually the performance of public and
    private providers of service in meeting the goals of the suit.
    f. Standards and compliance measurement. The standards, including outcome
    standards to be developed and implemented by defendants, that should be used to
    determine defendants’ continued compliance with Court-ordered requirements,
    and the way in which compliance with such standards should be measured.
    g. Substantial compliance standards. The degree of compliance that should be
    required with each of the standards recommended.
    h. Permanent monitoring. The steps necessary to establish permanent, objective,
    efficient, and effective post-termination monitoring of the programs serving class
    members by independent entities (for example, private accreditation services and
    independent monitoring bodies).
    I. Individual and community advocacy. The steps necessary to coordinate
    existing mechanisms and to develop needed mechanisms for the advocacy of the
    interests of class members, on a[n] individual and community-wide basis, in
    compliance with Court-ordered requirements, including but not limited to the use
    of court-appointed attorneys, guardianships, and medical decision-making
    procedures for class members.
    Id. at 97-98.
    H.       Appointment of Independent Court Monitor
    9
    In November 2000, the Court entered an Order granting the parties’ joint motion for the
    appointment of an independent Court Monitor. (Order Regarding the Appointment of an
    Independent Court Monitor, Nov. 21, 2000.) The Order specified that the duties of the Court
    Monitor were to include observing, monitoring, reporting findings, and making
    recommendations to the parties, the Special Master, and the Court regarding implementation of
    the Court’s Orders, and to submit quarterly reports on defendants’ “compliance” with the Court’s
    Orders. (Id. at 2-5.) The Order also provided that the “findings, recommendations and reports of
    the Court Monitor . . . may be introduced as evidence when relevant and admissible in
    accordance with the Federal Rules of Evidence.” (Id. at 5.) In order to perform these duties, the
    Monitor was granted broad access “to the persons, residences, facilities, buildings, programs,
    services, documents, records, personnel and materials the Monitor deems necessary or
    appropriate in performing [her duties].” (Id. at 4.)8
    I.      2001 Opinion and Order: Joint Stipulated Findings of Fact; Plan for
    Compliance; Consent Order and Settlement Agreement
    In 2001, after “lengthy negotiations” – almost two years of work by the Special Master,
    the parties, and an expert to the Special Master – the parties came to a series of agreements that
    “set forth a careful and detailed blueprint for achieving compliance with the Court’s Orders, for
    the development of permanent and independent mechanisms to safeguard the rights of class
    members, and for the phased withdrawal of judicial oversight of the District of Columbia’s
    mental retardation system as compliance with the Court Orders [wa]s achieved.” Evans v.
    8
    On January 19, 2001, Dr. Jane Haddad was appointed as the first Independent Court
    Monitor. After her resignation, effective February 10, 2004, the Court appointed, with the
    concurrence of the parties, Elizabeth Jones as the Court Monitor. Ms. Jones has continued to
    serve admirably in that capacity and has been of great assistance to the Court and to the parties.
    
    10 Williams, 139
     F. Supp. 2d 79, 81 (D.D.C. 2001) (“2001 Consent Order”). Upon consideration of
    these agreements, the Court, on March 30, 2001, (1) adopted the Parties’ Joint Stipulated
    Findings of Fact, id. at 96-107;9 (2) approved the 2001 Plan for Compliance and Conclusion of
    Evans v. Williams, id. at 85 (“2001 Plan”);10 and (3) entered a Consent Order, with a Settlement
    Agreement attached thereto. Id. at 85-96. Two aspects of these agreements remain critically
    important today: the 2001 Plan to achieve compliance and the creation of the Quality Trust in
    exchange for plaintiffs’ waiver of claims on noncompliance.
    1.     2001 Compliance Plan
    The 2001 Plan started from the premise “that there is already in place a declaratory
    judgment and permanent injunction recognizing a federal constitutional right to receive
    9
    As previously described by the Court, the joint stipulated findings of fact:
    painted a bleak picture as to defendants’ record of noncompliance. The findings
    acknowledged that there had been a “serious breakdown” in the District’s system
    of support for individuals with developmental disabilities and that the system,
    which had suffered from years of neglect and mismanagement, “urgently need[ed]
    to be fixed.” Evans, 139 F. Supp. 2d at 96-97; see also, e.g., id. at 98 (noting that
    District’s mental retardation and developmental delivery system was “broken”
    and needed to be “redefined and rebuilt”). The findings noted that defendants’
    compliance with the prior Court Orders had deteriorated following the closure of
    Forest Haven in 1991 and that defendants were not complying with many of the
    requirements of those Orders. Id. at 98. The findings also identified numerous
    “fundamental problems,” including problems with respect to staffing, staff
    training, and monitoring; management; reporting of and response to unusual
    incidents; safeguarding of class members’ funds; the budgeting process; and the
    District’s Medicaid Home and Community-Based Services waiver. See id. at
    98-107.
    Evans, 
    480 F. Supp. 2d at 286-87
    .
    10
    Clarence Sundram was the expert to the Special Master who “conceived, shaped, and
    drafted significantly” the 2001 Plan. (2001 Plan at 5 n.1). He was appointed as a co-Special
    Master on January 30, 2001. (Order, Jan. 30, 2001.)
    11
    individualized habilitative care and treatment in the least separate, most integrated, and least
    restrictive settings, and to be kept free from harm.” (2001 Plan at 6.) The Plan then identified
    (as the Court’s 1999 Order had requested) the agreed-upon “goals” of the existing Court orders.
    According to the Plan, the parties agreed that existing Court Orders embodied eight goals:
    (1) Appropriate individual habilitation in the community in the least separate,
    most integrated, and least restrictive environment;
    (2) Protection from harm;
    (3) Safeguarding consumers’ personal possessions;
    (4) Monitoring the service system;
    (5) Advocacy for consumers;
    (6) Adequate budget;
    (7) Timely payment of vendors; and
    (8) Essential systemic conditions.
    Evans, 139 F. Supp. 2d at 81.11 For each goal (or subgoal), the Plan identified the “relevant
    Court Orders,” the “specific tasks that must be performed to implement those Orders,” the “time
    frames within which the tasks must be performed,” the “specific outcome criteria for measuring
    compliance,” the “standard of compliance,” and the “methods by which evidence will be
    collected and evaluated to assess compliance.” Id. at 81-82.
    The Court approved the 2001 Plan “as, in effect, a statement of the conditions for the
    expected vacating of the Court’s relevant prior Orders.” Id. at 85. It was anticipated that
    [w]hile the Plan is not intended to be an independently enforceable document, the
    11
    The Court’s order and opinion included extensive factual findings documenting the
    District’s failure to meet each of the goals. Id. at 97-107.
    12
    parties do intend that there will be accountability for its implementation. The
    Plan requires periodic progress reports to the Special Master on its
    implementation and calls for status conferences with the Court to be scheduled at
    least bimonthly. The parties agree that if the Court finds that defendants have
    satisfied the outcome criteria set forth in the Plan, they also will be in compliance
    with the related Court Orders. Any failure of defendants to implement the tasks
    identified in the Plan so as to meet the requirements of the related Court Orders
    would be evidence of noncompliance with those Orders. The Plan provides that
    until the existing Court Orders are vacated, plaintiffs may seek appropriate
    judicial relief, including requesting orders requiring compliance with the Order(s)
    underlying the objectives of the Plan.
    Id. at 83.
    2.      Creation of the Quality Trust
    The Consent Order and attached Settlement Agreement provided that, in exchange for the
    plaintiffs waiving “any and all claims for past violations of the Court’s Orders,” the District
    would “endow and annually fund . . . a durable, independent, nonprofit organization that will
    monitor and advance the individual and collective interests of people with developmental
    disabilities in the District of Columbia’s service delivery system.” Id. at 86. Defendants agreed
    to fund the organization, denominated the Quality Trust, with a total of $31.5 million over eleven
    years.12 Ultimately, the goal was for the Quality Trust to be “an external monitoring body to
    permanently protect the interests of the class members once this case ends.” Id. at 83.
    ***
    The 2001 agreements, which the Court accepted and adopted, contemplated that as
    defendants satisfied the outcome criteria in the 2001 Plan for particular groups of Court Orders,
    they would move the Court to have those Orders vacated and dismissed with the ultimate goal
    12
    Of that amount, Quality Trust estimates that the District still has $5 million left to
    contribute. (Hr’g Tr. at 138, Dec. 17, 2009 [“12/17/09 Tr.”].)
    13
    that, over time, defendants would
    implement all of the required actions and meet the specified outcome criteria in
    order to successfully move the Court to vacate and dismiss the related Court
    Orders, except the declaratory judgment on the constitutional rights of the
    consumers to receive individualized habilitation in the least separate, most
    integrated and least restrictive environment and to be protected from harm.
    (2001 Plan at 9-10 (emphasis added).) Once the Court orders were vacated and dismissed, the
    plaintiffs agreed that they would not “seek recourse to the federal court to litigate individual
    violations of rights in this case pursuant to the declaratory judgment which will remain unless:
    (1) there are systemic violations of the declaratory judgment; or (2) legal remedies are
    unavailable in Superior Court (e.g., due to repeal of the statutes); or (3) there is a failure to
    adequately fund the Quality Trust pursuant to the Consent Order dated January 19, 2001.” (Id.)
    Since 2001, however, defendants have not invoked the procedures set forth in the 2001
    Plan, to which they agreed, to vacate any Court Orders based on their implementation of the
    necessary tasks and satisfaction of the specified outcome criteria.13 Accordingly, the Court
    Orders “continue to remain enforceable in federal court.” (Id.) Moreover, even though the 2001
    Plan itself was “not intended to be an enforceable document,” the parties agreed that plaintiffs
    “have a great interest in ensuring that the agreed upon actions identified in this Plan are in fact
    implemented effectively and in a timely manner by defendants to secure the benefits and
    protections provided for by the Court Orders,” and provided, therefore, that “in the event that
    defendants do not implement the provisions of this Plan effectively and on a timely basis,
    13
    As noted above (see supra note 2), defendants have now made half-hearted reference to
    a limited number of orders that they believe should be vacated (Mem. in Supp. of Defs.’ Mot. for
    Alternate Remedy at 3 [“Defs.’ Mem. re Alternate Remedy”]), but prior to this, defendants
    steadfastly maintained that modification was not realistic; instead, all orders must be vacated and
    the case dismissed. (See infra note 34.)
    14
    plaintiffs and plaintiff-intervenor retain the right to seek appropriate judicial relief, based on this
    evidence of noncompliance with the Court Orders, including Orders requiring specific
    performance of the Plan.” (Id.)
    J.      2004 Order
    In 2004, after several years of receiving discouraging monitor reports on the
    implementation of the 2001 Plan, this Court14 issued an order to address the “need for greater
    coordination among District of Columbia agencies which have responsibilities for actions that
    are necessary to achieve compliance with the 2001 Plan.” (Order at 1, Jan. 21, 2004 [“2004
    Coordination Order”].) As described therein, the parties had met with the Court on December
    12, 2003, and agreed that “the current lack of such coordination has impeded the timely
    completion of necessary tasks identified in the 2001 Plan.” (Id. at 1-2.) The 2004 Order
    reiterated that the District remained subject to the Court’s previous orders, which were issued “to
    effectuate the rights of class members to adequate habilitation in a manner least restrictive of
    their liberty” and that the purpose of the 2001 Plan was to require defendants to take certain
    actions to achieve compliance with those orders. (Id. at 1.) The Order required, inter alia, that
    the Mayor appoint a Deputy Mayor or other senior official “to be responsible for the day-to-day
    efforts of District of Columbia agencies to achieve compliance with this Court’s orders and the
    2001 Plan.” (Id. at 2.) That individual was to “have the necessary authority to supervise and
    direct the activities of” and “coordinate the efforts of all District of Columbia agencies” as
    necessary to “carry out their obligations under the 2001 Plan and previous orders of this Court,”
    14
    Shortly after the 2001 Plan was approved, Judge Harris retired and this case was
    reassigned to the undersigned.
    15
    and was to “cooperate with and report periodically to the Special Masters and Court Monitor on
    defendants’ progress,” and “appear before this Court at each status conference and report to the
    Court on behalf of defendants regarding the status of defendants’ compliance with the 2001 Plan
    and orders of this Court.” (Id. at 3.)15
    II.    MOTION FOR RECEIVERSHIP: LIABILITY PHASE
    In May 2006, plaintiffs filed a motion asking the Court to find defendants in
    noncompliance with the outstanding Court Orders and to place the District’s Mental Retardation
    and Developmental Disabilities Administration (“MRDDA”) into receivership.16 The Court
    bifurcated proceedings into a “liability” and a “remedy” phase. Evans, 
    480 F. Supp. 2d at 291
    (“March 2007 Liability Opinion”).
    While the liability phase was ongoing, several notable events occurred. On December
    20, 2006, the “Developmental Disabilities Services Agency,” later renamed the “Department on
    Disability Services,” was established by emergency legislation as a separate Cabinet-level
    agency to serve consumers formerly served by the MRDDA, including the Evans class members.
    Developmental Disabilities Services Management Reform Emergency Amendment Act of 2006,
    §§ 103, 105(1), (2). In January 2007, Adrian Fenty took office as Mayor for the District of
    Columbia. On February 5, 2007, defendants asked the Court to delay its liability ruling in light
    of the new administration’s “commitment to DDS and its consumers” and its newly adopted
    15
    Since January 2004, several different individuals have served in this capacity.
    Presently, the Mayor’s appointee is Peter Nickles, the Attorney General for the District of
    Columbia. But see infra pp. 30-31.
    16
    The United States, as plaintiff-intervenor, also filed a motion for an order to show cause
    why defendants should not be held in contempt. The Court denied that motion on March 30,
    2007. (Order, Mar. 30, 2007.)
    16
    “Systems Improvement Plan” in order “to allow sufficient time for the DDS to appropriately
    address the continuing concerns of the Court, the Monitor, the Department of Justice, and
    plaintiffs.” (Defs.’ Notice of Filing of Supplemental Information in Resp. to the Ct. Monitor’s
    Quarterly Report at 10, Feb. 5, 2007.) In making its request, the District indicated that it was
    “cognizant that much remains to be done to bring DDS into compliance with outstanding court
    orders and the 2001 Plan,” but promised the Court that the “Fenty Administration is fully
    committed to the success of the new agency, the delivery of improved services and care to the
    consumers served by the agency, and compliance with the 2001 Plan.” (Id. at 8.) At a status
    hearing the next day, the Court rejected this request and indicated that it intended to issue its
    liability ruling based on the record as of November 29, 2006, when the Court Monitor had filed
    her supplemental report as requested by the Court, but that information about improvements and
    accomplishments after that date would be considered in any remedy phase. (Hr’g Tr. at 23-24,
    Feb. 6, 2007.)
    On March 30, 2007, the Court issued its liability ruling, concluding that plaintiffs had
    met their burden to show that there had been “systemic, continuous, and serious noncompliance”
    with the Court’s prior Orders. Evans, 
    480 F. Supp. 2d at 325
    .
    A.        Findings: Health, Safety and Welfare
    The Court organized its findings in terms of these three broad subject areas: health, safety
    and welfare. Based on a record that closed in November 2006, the Court found that
    plaintiffs have demonstrated, by clear and convincing evidence, that defendants
    have failed to comply with existing Court Orders in the core areas of health,
    safety, and welfare. These failures are systemic in that they affect many class
    members served by a cross-section of providers and occur throughout defendants’
    service delivery system. They are serious in that they concern matters that are
    integral to class members’ health, safety, and well-being. And, they are
    17
    continuous in that the same issues of noncompliance have persisted year after
    year.
    
    Id. at 298
    . A brief summary of the Court’s findings follows.
    In the category of “health,” the Court found that:
    defendants have failed in many significant respects to accomplish the tasks and to
    achieve the outcome criteria in the 2001 Plan that relate to the Court’s Orders
    regarding the provision of health care and to comply with the terms of the Orders
    themselves. Defendants’ deficient performance with respect to these measures
    provides ample evidence that defendants have failed to comply with the Court’s
    Order that “[a] program of medical, dental and health related services which
    provides accessibility, quality and continuity of care is required,” as well as with
    Court Orders requiring development of habilitation plans and programs that
    incorporate all services needed by class members and implementation of
    appropriate training programs for all staff.
    
    Id. at 305
     (citations omitted).
    In the category of “safety,” the Court found that:
    defendants have failed in many significant respects to accomplish the tasks and
    outcome criteria associated with the Court’s Orders relating to class member
    safety and to comply with the terms of the Orders themselves. Defendants’
    performance in the areas discussed above provides ample evidence that
    defendants have failed to comply with the Court’s Orders prohibiting all acts of
    “physical or psychological abuse, neglect or mistreatment” of class members,
    requiring the prompt reporting and investigation of all such incidents and the
    prompt dissemination of the reports of such investigations to the Court Monitor
    and other interested parties, requiring the development and implementation of
    appropriate training programs for all staff, including staff assigned to residential
    settings, and requiring defendants to provide necessary monitoring mechanisms.
    
    Id. at 313-314
     (citations omitted).
    Finally, in the category of “welfare,” the Court found that defendants were not in
    compliance in several respects. First, in terms of the “least restrictive, most integrated setting
    requirement,” the Court found that:
    defendants have not complied with the Court’s 1978 Order that all class members
    be provided with “community living arrangements suitable to each, together with
    18
    such community-based day programs and services as are necessary to provide
    them within minimally adequate habilitation . . . in the least separate, most
    integrated and least restrictive community settings.”
    
    Id. at 319
     (quoting Evans, 
    459 F. Supp. at 484
    ). The Court also found serious problems in the
    areas of implementing “individual support plans” (“ISPs”) and thus in “ensuring that class
    members actually receive the services and supports they require,” id. at 320, and a failure to
    comply with orders regarding “adaptive equipment.” Id. at 321. Finally, the Court found
    problems in the area of case management, concluding that:
    defendants “fail[ed] to ensure that case managers complete the required number
    of visits and that they take appropriate action when a class member has been the
    subject of a serious incident”; “[f]ail[ed] to ensure that case managers are
    properly trained before receiving caseloads”; and that case managers “fail[ed] to
    ensure that ISPs are fully implemented.”
    Id. at 324.
    The Court summarized its findings as follows:
    As a result of these failings, class members continue to be placed in inappropriate
    and overly restrictive residential and day programs, rather than in the least
    restrictive, most integrated settings. Provider and MRDDA staff, including case
    managers, are not adequately trained, and case managers do not visit class
    members with the required frequency and do not adequately address deficiencies
    in class members’ care. In many instances, class members do not receive the
    needed services and supports that have been identified in their ISPs. Protocols
    necessary to protect class members’ health and safety, such as feeding,
    positioning, and behavioral plans, are routinely not followed. Health risks are not
    adequately assessed and monitored for many class members, and
    recommendations by health care providers are not implemented in a timely
    manner. While incidents of abuse and neglect of class members persist,
    defendants have failed to ensure that these and other serious incidents, including
    class member deaths, are investigated in a timely manner, that the results of such
    investigations are shared with providers, and that recommended corrective and
    preventive actions are implemented. Defendants have also compromised the
    monitoring process by altering death investigation reports.
    Id. at 324-25. These findings were the basis for the Court’s ultimate conclusion that defendants’
    19
    noncompliance with Court orders had been “systemic, continuous and serious.” Id. at 325.
    B.      Remedy
    As for the remedy of receivership sought by the plaintiffs, the Court observed:
    Although it is clear based on the tortured history of this case that there have been
    repeated failures to comply with the Court’s Orders, this determination is in no
    way determinative of the question whether plaintiffs are correct in their argument
    that a receivership should be imposed.
    Id. at 326. Rather, receivership is a “remedy of last resort,” that “should be undertaken only
    when absolutely necessary.” Id. (quoting District of Columbia v. Jerry M., 
    738 A.2d 1206
    ,
    1213 (D.C. 1999)).
    In light of the complexity of this inquiry, and the fact that “recent developments . . . are
    encouraging and will be highly relevant to the remedial phase of this action,” the Court
    determined that it would “enlist the assistance of the Special Masters, who have ably served in
    this capacity for many years, to make findings and recommendations to the Court that address,
    inter alia, the current status of defendants’ compliance, what are the available options for curing
    the identified deficiencies, and whether a receivership is the most effective and efficient remedy
    available to the Court.” Id. at 326. The Court instructed that the “determination whether other
    remedies are inadequate and whether receivership remains the only viable option to effectuate
    compliance with court orders is to be guided by a number of factors, including
    (1) “whether there were repeated failures to comply with the Court’s orders”; (2)
    whether further efforts to secure compliance would only lead to “confrontation
    and delay”; (3) whether leadership is available which can “turn the tide within a
    reasonable time period”; (4) “whether there was bad faith”; (5) “whether
    resources are being wasted”; and, (6) “whether a receiver can provide a quick and
    efficient remedy.”
    Id. (quoting Jerry M., 
    738 A.2d at 1213
     (quoting Dixon v. Barry, 
    967 F. Supp. 535
    , 550 (D.D.C.
    20
    1997))). The Court’s final observation was that “the daunting task of finding ways to remedy the
    problems still remains. In this regard, the Court expects the parties to continue their prior efforts
    to resolve this matter so that the plight of the class members can be improved as expeditiously as
    possible, and they will not have to continue to await the outcome of this painfully lengthy and
    cumbersome litigation.” Id. at 327.
    III.    MOTION FOR RECEIVERSHIP: REMEDY PHASE
    A.      Supplemental Order of Reference to the Special Masters
    Following the issuance of the March 30, 2007 decision, the parties conferred and jointly
    agreed on a supplemental order of reference to the Special Masters. (Supp. Order of Reference,
    May 3, 2007 [“2007 Reference Order”].) The 2007 Reference Order provided, inter alia, as
    follows:
    Both Margaret G. Farrell and Clarence J. Sundram have served as Special Masters
    in this case for many years under prior Orders of Reference. The Court finds that
    it is justified and necessary to continue their appointment to assist the Court for as
    long as the Court deems necessary in this matter.
    (Id. at 1.) It further provided that:
    The Masters are authorized to conduct proceedings relating to the necessity for
    remedial relief, including, as needed, discovery, hearings, mediation and
    settlement negotiations. At the conclusion of such proceedings, the Masters will
    issue a report to the Court making recommended findings of fact, conclusions of
    law and recommendations regarding appropriate remedies.
    (Id. at 2.) Following the issuance of the Special Masters’ report and recommendations, the
    parties were to “file objections to (or file a motion to adopt or to modify) such order, report or
    recommendations.” (Id. at 4.) The parties were directed that all objections should “specifically
    identify the portions of the order, or report containing proposed findings of fact, conclusions of
    law and recommendations for remedial action, to which objection is made and the basis for the
    21
    objection.” (Id.) Finally, the Order provided that this Court would review de novo “all
    objections to the Masters’ proposed findings of fact and recommendations regarding remedial
    relief” and “all objections to conclusions of law made or recommended by the Masters.” (Id.)
    B.      September 12, 2007 Consent Order (“90-Day Order”)
    After a quarterly status conference on August 9, 2007,17 the parties agreed to develop,
    and the Court ultimately entered, a consent order “setting forth a limited number of concrete,
    short-term goals related to retaining and increasing the number of qualified providers and
    improving the health and safety of class members” that the District agreed to achieve “during the
    three-month period from October 1, 2007, to December 31, 2007.” (Order at 1, Sept. 12, 2007
    [“2007 90-Day Consent Order”]). Pursuant to that Order, defendants agreed to take a number of
    specific actions that were focused on these two critical goals. (Id. at 2.) The Special Masters
    were tasked with determining defendants’ compliance with the 2007 90-Day Consent Order,
    beginning in January 2008. (Id. at 1.)
    On August 18, 2008, the Special Masters filed their Report and Recommendation
    regarding defendants’ compliance with the 2007 90-Day Order. (Special Masters’ Report &
    Recommendation Regarding Defs.’ Compliance with the Consent Order of Sept. 12, 2007, Aug.
    18, 2008 [“2008 Special Masters’ Report”].) The 2008 Special Masters’ Report concluded that
    overall defendants “did not demonstrate substantial compliance with six out of the 13 provisions
    of the Consent Order that they recently agreed-upon, and whose obligations they concede they
    17
    At the August 9, 2007 status conference, the director of DDS, Judith Heumann,
    informed the Court that (1) the name of the MRDDA was changing to the Developmental
    Disabilities Administration (“DDA”); and (2) that Laura Nuss would be the new deputy
    overseeing the DDA. (Hr’g. Tr. at 5, Aug. 9, 2007.)
    22
    clearly understood.”18 Id. at 107.
    C.      Monitoring Compliance
    At the same time it issued the 2007 90-Day Consent Order, the Court ordered the parties
    to “file with the Court the agreed-upon methodology to be used by the Court Monitor to monitor
    defendants’ compliance with the requirements of the 2001 Plan and the existing Court Orders by
    January 10, 2008.” (Minute Order, Sept. 12, 2007). Following the issuance of this Order, the
    Court Monitor circulated to the parties and the Special Masters a proposed monitoring protocol.
    On November 21, 2007, defendants filed a notice stating:
    By communication of November 16, 2007, faced with the expenditure of
    substantial resources and time to develop the above-referenced methodology,
    Defendants informed the Court Monitor that a meeting to develop a methodology
    would not be needed since Defendants would not assert that conditions have so
    fundamentally changed at this point that such comprehensive monitoring is
    appropriate. Accordingly, Defendants expressed the view that there was no need
    for the comprehensive monitoring proposed by the Court Monitor and the
    significant expense attendant thereto that would be incurred.
    (Defs.’ Notice Concerning Proposed Comprehensive Monitoring at 2, Nov. 21, 2007 (emphasis
    added).) By May 2008, a monitoring protocol had still not been agreed upon. Just prior to the
    status conference set for May 15, 2008, defendants filed a motion to stay discovery during the
    remedial phase of the case, which was denied by the Court. (Hr’g Tr. at 38, May 15, 2008.) On
    May 19, 2008, the Court issued a scheduling order to govern the remedy phase.
    18
    On September 15, 2008, defendants filed a motion for an order modifying the 2008
    Special Masters’ Report to find defendants in compliance with the 2007 90-Day Consent Order.
    (Defs.’ Mot. to Modify the Special Masters’ Report & Recommendation, Consistent with Defs.’
    Objections, to Find Defs. in Compliance with the Consent Order of Sept. 12, 2007, at 1, Sept. 15,
    2008.) On October 6, 2008, the Court held this motion in abeyance and to the extent it is
    necessary to address this motion, it will be done in the Court’s opinion regarding defendants’
    objections to the 2008 Special Masters’ Report and Recommendation.
    23
    On June 13, 2008, plaintiffs, in response to the Court’s request, filed a summary of the
    remedies they were seeking. That filing set forth a range of possible remedies, “running from no
    action by the Court up to court-appointed receivership over the entire Department on Disability
    Services, with oversight of all District agency functions pertaining to Evans class members and
    other individuals with developmental disabilities served by the defendants.” (Pls.’ Filing on
    Remedies at 1, June 13, 2008.) Among these alternatives, plaintiffs endorsed the remedy of
    appointing a “Special Administrator,” who would “oversee[] government agencies and functions
    pertaining to class members until the District achieves substantial compliance with the Court’s
    Orders,” but who would not have all the powers of a receiver. (Id. at 3.)
    D.      Proceedings Before the Special Masters
    Following additional discovery and pretrial proceedings, the Special Masters conducted a
    three-day trial on December 10-12, 2008. Direct testimony from both fact and expert witnesses
    was presented by declaration or excerpts from depositions. (Special Masters’ Final Pretrial
    Order at 6, Nov. 28, 2008.) All witnesses were subject to live cross-examination. (Trial Tr.,
    Dec. 10, 2008; Trial Tr., Dec. 11, 2008.) Plaintiffs presented the testimony of two fact
    witnesses19 and two expert witnesses.20 Defendants presented the testimony of six fact
    witnesses21 and three expert witnesses.22 In addition, more than 200 exhibits were introduced
    19
    John M. Cook, Executive Director, L’Arche, Inc.; Thomas F. Wilds, member of
    interagency rate-setting task force.
    20
    Martha B. Knisley; Lewis H. Spence, lecturer, Harvard School of Education and
    Kennedy School of Government (remedy).
    21
    Laura L. Nuss, Deputy Director of the Department on Disability Services, responsible
    for the Developmental Disabilities Administration; John McCarthy, Deputy Director of the
    Department of Health Care Finance and District of Columbia State Medicaid Director; Kathy
    Sawyer, former consultant and Interim Director, DDS, former Evans Compliance Officer
    24
    into evidence. Subsequently, both parties submitted Proposed Findings of Fact and Conclusions
    of Law, as well as post-trial briefs. The Quality Trust for Individuals with Disabilities filed an
    amicus brief in support of plaintiffs’ motion and for the appointment of a Special Administrator.
    On February 9, 2009, closing arguments were heard by the Special Masters.
    E.      Districts’ Motions to Vacate: April 20, 2009
    On April 20, 2009, shortly before the Special Masters issued a draft of their Report and
    Recommendation, defendants filed a motion pursuant to Federal Rule of Civil Procedure
    60(b)(5) to vacate all consent orders and dismiss the case. Defendants asserted that “[c]ontinued
    federal-court oversight is no longer equitable, as there is no question that the District has
    remedied the alleged constitutional and statutory violations that gave rise to the 1978 Consent
    Order and its progeny” and “there is no reasonable basis for asserting that the District will revert
    to violating the law if the Court’s orders are lifted.” (Defs.’ Mot. to Vacate Consent Orders and
    Dismiss Action at 1, Apr. 20, 2009.) For the first time, in a litigation that has been ongoing for
    more than 30 years and despite repeated promises to comply with the existing Court orders,
    defendants took the position that their noncompliance was irrelevant to the question of whether
    the Court should continue enforcing its orders because those orders went “beyond minimum
    standards necessary to satisfy constitutional requirements.” (Id. at 3.) In a minute order filed on
    May 1, 2009, the Court advised the parties that no opposition to defendants’ motion should be
    (through Jan. 31, 2008) and former Interim Administrator, MRDDA; Judith Heumann, Director,
    DDS; Amy Brooks, President of RCM, a provider agency; Lisa Alexander, M.D., DC HRP.
    22
    David L. Jackson, M.D., PhD, President, Jackson & Assocs. (2007 mortality review and
    follow-up on recommendations for improvement); Nancy Thaler, Executive Director, National
    Association of State Directors of Developmental Disabilities Services; and John Sumner, Ph.D
    (statistical analysis).
    25
    filed because it intended to hold it in abeyance until it received the Special Masters’ final Report
    and Recommendation.
    F.      Special Masters’ Report and Recommendations
    On May 22, 2009, the Special Masters circulated, as required by the 2007 Supplemental
    Order of Reference, a draft of their proposed findings of fact and conclusions of law for
    comment. In that draft, the Special Masters “recommended that the Court’s 2004 Order be
    amended to provide for a Special Compliance Officer to be jointly appointed by the Court and
    the Mayor with enhanced authority to coordinate and direct the activities of the various District
    agencies urgently needed to deliver constitutionally acceptable services to the plaintiff class.”
    (2009 Special Masters’ Report at 4.) The draft recommended “that the Court appoint the Deputy
    Director of DDS/DDA, Laura Nuss, as the Special Compliance Officer merging in one person
    the legal responsibility under local law with the responsibilities and authority to be conferred by
    the Court, to lead defendants’ efforts to achieve compliance with the court orders.” (Id. at 135.)
    The Special Masters believed that “this least intrusive, and least expensive, remedy was most
    likely . . . to achieve compliance with Court Orders.” (Id. at 4.) However, this remedy “required
    the Mayor’s agreement.” (Id.) On July 6, 2009, the parties filed their comments on and
    objections to the draft report. Defendants’ comments indicated that the Mayor would not agree
    to the proposal to appoint a Special Compliance Officer, making that remedy “no longer a viable
    one.” (Id. at 135.)
    On August 14, 2009, the Special Masters filed their final Report and Recommendations,
    based on the record from November 29, 2006, the close of the record for the liability phase,
    through December 2008, when they closed the record before them. (Id. at 3.) As described
    26
    herein, the Special Masters found that “plaintiffs had proved by clear and convincing evidence
    that defendants continue to be in serious noncompliance with critical provisions of outstanding
    court orders” in the areas of health, safety, and welfare. (Id.) They recommended as a remedy
    the appointment of an “Independent Compliance Administrator accountable only to the Court to
    supervise and coordinate defendants’ serial compliance with individual court ordered obligations
    so that the suit may be dismissed in three years time or less.” (Id. at 4-5).
    1.       Findings of Fact and Conclusions of Law
    a.     Health
    In the area of health, the Special Masters found that defendants were noncompliant in
    several significant respects. First, regarding medical care, they found that defendants had “failed
    to completely perform some or all of the following duties”: “documenting significant health
    problems in class members’ health management plans; monitoring implementation of health
    plans; implementing recommendations put forward by class members’ physicians and medical
    specialists and completing lab work and physician-ordered diagnostic tests.” (Id. at 26-27.)
    Thus, they concluded:
    The evidence in the record indicates that a significant portion of the plaintiff class
    have health care needs that are not identified in their health plans. Furthermore,
    too often needs identified in health plans are not met because health plans are not
    implemented – i.e. diagnostic tests, consultations and treatments and follow up
    appointments are not provided or documented in their health records.
    (Id. at 31.) The Special Masters also found “ongoing and significant problems with the delivery
    of timely and appropriate mental health and behavioral healthcare.” (Id. at 35.) These problems
    included:
    a) lack of access to sufficient psychiatric and psychological services; b) improper
    professional practices that are inconsistent with professional standards; c)
    27
    recommended clinical therapies not being implemented; d) the failure to integrate
    the use of psychotropic medications into an overall treatment plan; e) the failure
    to obtain informed consent and approval from Human Rights Committees for use
    of these restrictive measures; and f) the lack of monitoring of the usage and side
    effects of psychotropic medications.
    (Id.)23 Finally, the Special Masters found that “delays in obtaining guardianship for the
    provision of informed consent for medical and dental treatment of class members . . . have
    continued” (id. at 45), sometimes “for months, sometimes more than a year, after the need for a
    guardian is first identified.” (Id. at 50.) As a result, treatment is delayed and class members
    suffer harmful consequences. (Id. at 49-50.)
    Based on these findings, the Special Masters concluded that “plaintiffs have established
    by clear and convincing evidence” that defendants continue “to be in non-compliance with . . .
    outstanding consent orders” with regard to (1) “class members’ health” (id. at 31); (2) “mental
    and behavioral health care” (id. at 41-42); and (3) timely appointment of guardians. (Id. at 49-
    50.)
    b.      Safety and Protection from Harm
    The Special Masters found the following problems with respect to defendants’
    obligations to ensure plaintiffs’ safety and protection from harm: (1) “a significant number of
    untimely investigations” into “serious reportable incidents” and deaths (id. at 52-53); (2) “some
    IMEU reports continue to fail to thoroughly investigate serious reportable incidents” (id. at 54);
    (3) except for Level I incidents, “the investigation report format does not inquire about potential
    causes and contributory factors leading to the incident under investigation” (id. at 56); (4) an
    23
    “About one third of the class members (228) receive psychotropic medications,” and
    “305 class members have behavior support plans.” (Id. at 35.)
    28
    inability to “identif[y] and address[] systemic issues arising in investigations (id. at 57); (5)
    “numerous instances of providers filing late incident reports or no reports at all, conducting
    inadequate investigations, or failing to conduct required investigations with no recommendations
    for or evidence of enforcement actions being taken in response to these deficiencies” (id. at 60);
    (6) “[i]ncidents of harm . . . , including serious physical injury, physical abuse and neglect” (id.
    at 60); (7) harm resulting from “delays in treatment due to problems with getting informed
    consent (id. at 61); (8) “harm due to inadequate health care management” (id.); and (9) harm
    resulting from problems with the District’s “transportation broker contract.” (Id. at 64).
    Based on these findings, the Special Masters concluded that “while there are some
    nascent signs of progress in a few areas,” there was “clear and convincing evidence that the
    problems being experienced by class members in the area of safety and protection from harm are
    continuing, serious and systemic.” (Id. at 67.)
    c.      Welfare
    In terms of court orders concerning plaintiff’s “welfare,” the Special Masters found the
    plaintiffs had “not sustained their burden of proving by clear and convincing evidence
    non-compliance with court orders requiring residential placements in less restrictive settings”
    (id. at 72); with court orders requiring that “all class members have written ISPs containing
    current habilitation plans, behavioral support plans and health plans” (id. at 78); or with court
    orders requiring a minimum of eight visits per year by a service coordinator/case manager. (Id.
    at 82). However, they did find continuing problems in the following areas: (1) segregated day
    programs with arts and crafts as the primary activity and a lack of opportunity for community
    experiences (id. at 73-74); (2) supported employment (id. at 74); (3) implementation of ISPs (id.
    29
    at 77-79); and (4) service coordinators not ensuring that ISPs are fully implemented or following
    up when they are not. (Id. at 81-84.)
    Based on these findings, the Special Masters concluded that there is “clear and
    convincing evidence” that defendants have “not met their obligation . . . to provide adequate
    habilitation in non-residential, least restrictive, community-integrated settings” (id. at 74), or to
    “[p]rovide all necessary and proper monitoring mechanisms to assure that community living
    arrangements, programs and supportive community services of the necessary quantity and
    quality are provided and maintained.” (Id. at 83-84).
    d.      Interagency Coordination
    As the Special Masters noted,
    [a]lthough the primary responsibility for providing timely and effective services
    and supports to class members rests with DDS/DDA, the success of this enterprise
    depends upon the coordinated efforts of several District agencies, including
    MAA/DHCF (formerly the Medical Assistance Administration (MAA) in the
    Department of Health (DOH) and now the Department of Health Care Finance
    (DHCF)), through which most of the funding is provided, the Health Regulation
    and Licensing Agency (HRLA) in the DOH, which is responsible for licensing
    and enforcement with respect to ICFs/MR, the Office of the Inspector General,
    which has investigative responsibilities for Medicaid fraud and abuse, the Office
    of Attorney General which files petitions for guardianships in court, and other
    agencies involved in the personnel, procurement, and budget process . . .
    includ[ing] the Office of Contracts and Procurement, which has a significant role
    in the contracting process.
    (Id. at 84.) As described supra, the 2004 Coordination Order was aimed at improving
    interagency communication coordination. The Special Masters found that despite evidence of
    improvement, “[t]here has been little evidence submitted regarding specific compliance with [the
    2004 Order].” (Id. at 90.) According to the Special Masters
    [w]hat is missing is evidence of leadership or coordination by the Mayor’s
    designee—the central point of the order—to give focus, direction and priority to
    30
    interagency communication and coordination, to identify planned actions of one
    agency that may adversely affect the mission of another and to take proactive
    steps to prevent such a consequence. In the absence of evidence of such efforts,
    the interagency efforts at the staff level between agencies have not been
    consistently successful, and gaps in communication and coordination have
    resulted in harm to class members.
    (Id. at 90.) Indeed, the Special Masters found that “[t]he evidence is that leaders in the key
    agencies that have the most significant interagency relationship . . . were unaware of the existing
    court order or of the responsibility of the Mayor’s designee in implementing it.” (Id. at 92.)
    These findings led the Special Masters to conclude that
    the current lack of awareness by key senior officials of the Order’s existence and
    its requirements, coupled with the absence of evidence of regular interagency
    meetings or communications with the Mayor’s designee regarding significant
    initiatives, and the evidence of breakdowns in interagency coordination leading to
    the problems discussed above, are all clear and convincing evidence of ongoing
    noncompliance with this court order which was that this Court Order has not been
    implemented as intended to remedy a long-standing problem of lack of
    interagency coordination.
    (Id. at 93.)
    2.      Remedy
    The Special Masters concluded “that the plaintiffs have demonstrated by clear and
    convincing evidence that there is a need for additional remedial measures ordered by the Court.”
    (Id. at 133.) Having been unsuccessful in their attempt to get defendants to agree to their first
    choice of remedy, and after many years of futile attempts to reach an agreement with the Fenty
    Administration as to a workable remedy, the Special Masters’ final report recommended the
    appointment of an “Independent Compliance Administrator” who “would be appointed by the
    Court, be accountable only to the Court and would not hold an executive appointment.” (Id. at
    134.) As described by the Special Masters, the Independent Compliance Administrator would
    31
    not have the same powers of a receiver but would
    serve as the focal point for the compliance efforts of the defendants and work in
    close collaboration with them, resulting in regular submissions of compliance
    reports as set forth in the 2001 Plan, and phased judicial disengagement from
    active supervision of the defendants’ developmental disabilities service system
    within three years. The Independent Compliance Administrator is not intended to
    have the powers of a receiver or to generally displace the power and authority of
    agency heads or subordinate officers. Rather, the authority and role of the
    Independent Compliance Administrator is limited to actions necessary to achieve
    compliance with the court orders within a three year period. All District agencies
    and personnel should be directed to cooperate with the Independent Compliance
    Administrator. If there is a lack of cooperation, or resistance or intransigence, the
    Independent Compliance Administrator should be required to report it
    immediately to the Special Masters or the Court.
    (Id. at 134-35.)
    IV.    CURRENT PROCEDURAL POSTURE
    At a status conference on August 19, 2009, the Court set a briefing schedule for plaintiffs
    to respond to defendants’ motion for vacatur and dismissal, combined with a timetable for filing
    objections to the 2009 Special Masters’ Report. Pursuant to the Court’s order, defendants
    renewed their motion to vacate the consent orders and dismiss the action and combined it with
    their objections to the 2009 Special Masters’ Report. (Defs.’ Renewed Mot. to Vacate Consent
    Orders and To Dismiss Action, Oct. 7, 2009 [“Defs.’ Mot. to Vacate”].) On November 6, 2009,
    plaintiffs filed their opposition to that motion (combined with their endorsement of the Special
    Masters’ Report and Recommendations (Pls.’ Resp. to Defs.’ Objections to the Special Masters’
    Report & Recommendation, and Opp’n to their Mot. to Vacate All Prior Orders and Dismiss the
    Case, Nov. 6, 2009 [“Pls.’ Opp’n”]). Plaintiff-intervenor, the United States, and the Quality
    Trust, as amicus curiae, also filed oppositions to defendants’ motion. (Pl. Intervenor’s Opp’n to
    Defs.’ Renewed Mot. to Vacate Consent Orders and To Dismiss Action, Nov. 6, 2009; Amicus
    32
    Curiae Br. of Quality Trust for Individuals with Disabilities, Inc., Nov. 11, 2009 [“Quality Trust
    Opp’n”].) Defendants filed their reply on December 2, 2009. (Defs.’ Consolidated Reply in
    Support of Mot. to Vacate Consent Orders and To Dismiss Action, Dec. 2, 2009.) On December
    17-18, 2009, the Court heard argument on defendants’ motions to vacate and to dismiss and on
    whether to adopt the 2009 Special Masters’ Report. The Court will address herein defendants’
    motions and will address plaintiffs’ request that the Court adopt the 2009 Special Masters’
    Report in a subsequent memorandum.
    ANALYSIS
    Defendants have moved under Federal Rule of Civil Procedure 60(b)(5), “at the
    conclusion of a period of monitoring not to exceed three months,24 to vacate the Consent Order
    entered on June 14, 1978 . . . together with all subsequent remedial orders, and to dismiss the
    action.” (Defs.’ Mot. to Vacate at 1.)
    Rule 60(b)(5) provides that “the court may relieve a party or its legal representative from
    a final judgment, order, or proceeding” if “the judgment has been satisfied, released or
    discharged; it is based on an earlier judgment that has been reversed or vacated; or applying it
    prospectively is no longer equitable . . . .” Fed. R. Civ. P. 60(b)(5) (emphasis added).
    Defendants seek relief solely on the ground that enforcing the existing orders prospectively is
    “no longer equitable.” (Defs.’ Mot. to Vacate at 4.) Conceding they are not in compliance with
    existing court orders (see 12/17/09 Tr. at 14-16), defendants nonetheless contend that all court
    24
    Under their latest filing, defendants propose the period of court monitoring and
    supervision to end at the end of 2010. (Defs.’ Mot. for Alternate Remedy at 2.). Defendants,
    however, seek to have the Court accept their alternative remedy while still preserving their rights
    to appeal the denial of their motion for vacatur and dismissal. (Id. at 2 & n.2.)
    33
    orders should be vacated because they have “remedied the alleged constitutional and statutory
    violations that gave rise to the 1978 Consent Order and its progeny, and continued federal-court
    oversight is therefore no longer either equitable or permissible.” (Mem. in Supp. of Defs.’ Mot.
    to Vacate at 3 [“Defs.’ Mem.”] (citing Horne v. Flores, 
    125 S. Ct. 2579
     (2009)).
    A party seeking modification of a judgment or order on the ground that applying it
    prospectively is no longer equitable “bears the burden of establishing that a significant change in
    circumstances warrants revision of the decree.” Rufo v. Inmates of Suffolk County Jail, 
    502 U.S. 367
    , 383 (1992); Horne, 129 S. Ct. at 2593. A party seeking relief “may meet its initial burden
    by showing . . . a significant change in either factual conditions or in law.” Rufo, 
    502 U.S. at 384
     (emphasis added); Horne, 129 S. Ct. at 2593. Changed factual conditions may include
    when “‘the objects of the decree have been attained.’” Horne, 129 S. Ct. at 2596 (quoting Frew
    v. Hawkins, 
    540 U.S. 431
    , 442 (2004)). “To determine the merits of this claim, [a court]
    ‘need[s] to ascertain whether ongoing enforcement of the original order [is] supported by an
    ongoing violation of . . . law.’” 
    Id.
     at 2597 (citing Milliken v. Bradley, 
    433 U.S. 267
    , 282
    (1977)); see also Frew, 
    540 U.S. at 442
     (“The federal court must exercise its equitable powers to
    ensure that when the objects of the decree have been attained, responsibility for discharging the
    State’s obligations is returned promptly to the State and its officials.”) If the party seeking
    modification or vacatur can establish that the “objective of the [district court’s] order . . . has
    been achieved” and “a durable remedy has been implemented, continued enforcement of the
    order is not only unnecessary, but improper.” Horne, 129 S. Ct. at 2595. In the alternative, a
    significant change in law may warrant modification or vacatur of a decree “when the statutory or
    decisional law has changed to make legal what the decree was designed to prevent.” Rufo, 502
    34
    U.S. at 388; see also Horne, 129 S. Ct. at 2595 (“[C]ourts must remain attentive to the fact that
    ‘federal-court decrees exceed appropriate limits if they are aimed at eliminating a condition that
    does not violate [federal law] or does not flow from such a violation.’” (quoting Milliken, 
    433 U.S. at
    282 )).
    In considering a request for modification in an institutional reform case, a district court
    must take a “flexible approach.” Horne, 129 S. Ct. at 2594; see also Rufo, 
    502 U.S. at 381
    ; Frew,
    
    540 U.S. at 441
    . “A flexible approach allows courts to ensure that ‘responsibility for discharging
    the State’s obligations is returned promptly to the State and its officials’ when the circumstances
    warrant.” Horne, 129 S. Ct. at 2595 (quoting Frew, 
    540 U.S. at 442
    ). “If the State establishes
    reason to modify the decree, the court should make the necessary changes; where it has not done
    so, however, the decree should be enforced according to its terms.” Frew, 
    540 U.S. at 442
    .
    Relief is warranted if the significant change “renders continued enforcement ‘detrimental to the
    public interest.’” Horne, 129 S. Ct. at 2593 (quoting Rufo, 
    502 U.S. at 384
    ).
    Defendants contend that there has been both a significant change in law and a significant
    change in factual conditions and that these changes satisfy Horne’s requirements for vacatur.
    Defendants could, of course, obtain vacatur by complying with the court orders. However, they
    concede they have not achieved compliance. (12/17/09 Tr. at 20-21.) Nonetheless, they argue
    that the objects of the court orders have been attained because (1) the scope of the right to
    habilitation recognized in the 1978 Consent Order and the many subsequent consent orders is
    premised on an incorrect understanding of the law, as established by the Supreme Court’s 1982
    decision in Youngberg and, therefore, those parts of the consent orders that are dependent on that
    definition are “extraconstitutional,”(i.e., not based on any constitutional violation) and thus are
    35
    legally unenforceable; and (2) the remaining parts of the 1978 Consent Order and subsequent
    consent orders impose requirements that exceed minimal constitutional standards, and thus,
    under Horne, defendants are entitled to vacatur once they achieve the minimum, which they
    claim to have done.
    Defendants’ argument for vacatur fails because (1) Youngberg does not represent a
    significant change in law (Section I(A)); (2) even if Youngberg constituted a significant change,
    defendants failed to make that argument within a reasonable time after Youngberg was decided
    (Section I(B)); (3) no matter how Youngberg is interpreted, it can only support a limited
    modification of the consent orders (Section I(C)); (4) defendants have misinterpreted Horne
    when arguing that the objectives of the consent decrees have been met because they have
    satisfied the constitutional floor (Section II(A)); and (5) defendants have failed to establish that a
    durable remedy is in place (Section II(B)).
    I.     DEFENDANTS ARE NOT ENTITLED TO VACATUR BASED ON A CHANGE
    IN LAW
    A.      Youngberg Was Not a Significant Change in Law
    According to defendants, Youngberg was a significant change in law because “[i]n its
    1978 Consent Order, this Court adopted a much more expansive definition of the Fifth
    Amendment right to habilitative care and treatment” than Youngberg recognizes or permits.
    (Defs.’ Mem. at 16 n.13.) Specifically, defendants take issue with the portions of the 1978
    Consent Order, to which they agreed, emphasized below:
    Each class member has a federal constitutional right, based upon the Due Process
    Clause of the Fifth Amendment, to receive habilitative care and treatment in the
    alternative least restrictive of individual liberty and to be kept free from harm.
    Habilitation is the process by which a resident is assisted in acquiring and
    36
    maintaining those life skills which enable him to cope more effectively with the
    demands of his own person and of his environment and to raise the level of his
    physical, mental, and social capabilities. Habilitation includes but is not limited
    to[] programs of formal, structured education and training.
    Habilitative care in the alternative least restrictive of individual liberty means
    living as normally as possible and receiving appropriate individualized services
    in the community in the least separate, most integrated and least restrictive
    settings.
    As used in this Order, “integrated” refers to the integration of mentally retarded
    persons with nonretarded persons in the community.
    (Id. (quoting 1978 Consent Order at 2 ¶ 3) (emphases added).) According to defendants, “[t]he
    portions of this definition emphasized above are not required by the Fifth Amendment’s due
    process clause but, rather, reach far beyond any constitutionally guaranteed minimum.” (Id. at
    16-17 n.13) Defendants maintain, for the first time in over 30 years, that they “cannot now be
    bound by their three-decades-old consent to the use of an overly expansive, erroneous
    definition.” (Id.) Rather, they argue, “this Court should disregard the 1978 Consent Order’s
    incorrect statement of the applicable standard and implement the correct standard, which the
    District has more than satisfied.” (Id. at 17 n.13.)
    It is well-established that a Court can modify or vacate a consent decree based on a
    significant change in law. In many cases where this type of argument has been raised, it is
    undisputed that the law has in fact changed, that a legal basis for the decree has evaporated, and
    the only question for the Court is whether the change in the legal landscape warrants
    modification (or vacatur) of the decree. See, e.g, Sys. Fed’n No. 91, Ry. Employes’ Dep’t, AFL-
    CIO v. Wright, 
    364 U.S. 642
    , 652 (1961) (“The parties have no power to require of the court
    continuing enforcement of rights the statute no longer gives.”); Sweeton v. Brown, 
    27 F.3d 1162
    ,
    1164-65 (6th Cir. 1994) (en banc) (dissolving injunction pertaining to state parole procedures
    37
    where subsequent controlling caselaw established that there was no federal due process interest
    at stake and thus that the “legal theory and analysis upon which the consent decree was
    formulated was erroneous”); Evans v. City of Chicago,
    10 F.3d 474
    , 480 (7th Cir. 1993) (en banc)
    (vacating consent decree because its “continued enforcement” was “inequitable” where the
    underlying “substantial claim” under federal law had evaporated); Doe v. Briley, 
    511 F. Supp. 2d 904
    , 923-26 (M.D. Tenn. 2007) (dissolving consent decree precluding publication of names of
    persons arrested but not convicted due to Supreme Court decision holding that due process did
    not protect against stigmatizing publications by law enforcement officials), aff’d, 
    562 F.3d 777
    (6th Cir. 2009).
    Here, however, the first question for the Court is whether there has in fact been a
    significant change in the law. See, e.g., United States v. Rueth Dev. Co., 
    335 F.3d 598
    , 604 (7th
    Cir. 2003) (refusing to modify or vacate consent decree where Supreme Court decision “did not
    expressly make [the relevant regulation] illegal” even though that “reading might be the only
    logical extension of the case”); see also Rufo, 
    502 U.S. at 389
     (“To hold that a clarification in the
    law automatically opens the door for relitigation of the merits of every affected consent decree
    would undermine the finality of such agreements and could serve as a disincentive to negotiation
    of settlements in institutional reform litigation.”) That is, does the 1978 Consent Order, in
    defendants’ words, use “an overly expansive, erroneous definition” of the right to habilitative
    care and treatment. (Defs.’ Mot. at 14 n.2.) As explained herein, the answer to this question is
    simply that defendants cannot argue for vacatur based on a significant change in the law.
    1.      Youngberg
    In Youngberg, the Supreme Court considered “for the first time the substantive rights of
    38
    involuntarily committed mentally retarded persons under the Fourteenth Amendment to the
    Constitution.” 
    457 U.S. at 314
    . The plaintiff in Youngberg, Nicholas Romeo, had been
    involuntarily committed under the laws of Pennsylvania to a state institution. As described in
    the Supreme Court’s decision, he was “profoundly retarded,” with “the mental capacity of an 18-
    month old child, with an I.Q. between 8 and 10,” who could not “talk and lack[ed] the most basic
    self-care skills.” 
    Id. at 309
    . He had been committed to a state facility at the age of 26 because
    his mother could no longer care for him after his father’s death. After he suffered a number of
    injuries, both self-inflicted and from other residents, his mother filed a complaint in federal
    district court. The precise question before the Supreme Court was whether a person
    involuntarily committed to a state institution for the mentally retarded had “substantive rights
    under the Due Process Clause of the Fourteenth Amendment to (I) safe conditions of
    confinement; (ii) freedom from bodily restraints; and (iii) training, or ‘habilitation.’”25 
    Id. at 309
    .
    Based on its prior decisions, the Court concluded, without the need for explication, that
    the plaintiff’s right to safe conditions and right to freedom from bodily restraint were the “core
    of the liberty protected by the Due Process Clause,” noting that since both rights survived
    criminal conviction and incarceration, they certainly survived involuntary commitment. 
    Id. at 315-16
     (quotations omitted). As for the right to habilitation, the Court had never before
    25
    It was conceded by the State of Pennsylvania that the plaintiff “ha[d] a right to adequate
    food, shelter, clothing, and medical care,” so the Court limited its inquiry to the narrow question
    of “whether liberty interests also exist in safety, freedom of movement, and training.”
    Youngberg, 
    457 U.S. at 315
     (emphasis added). As discussed infra, this fact is relevant because
    no matter how Youngberg is interpreted, it has no effect on a host of issues covered by the
    consent decrees and the 2001 Plan. See infra pp. 55-58.
    39
    considered whether such a right existed or what its scope might be. Ultimately, it held that
    plaintiff had a right to the habilitation he sought – a right to “minimally adequate or reasonable
    training to ensure safety and freedom from undue restraint.” 
    Id. at 319
    . In reaching this
    conclusion, the Court noted that because the plaintiff “seeks only training related to safety and
    freedom from restraints, this case does not present the difficult question whether a mentally
    retarded person, involuntarily committed to a state institution, has some general constitutional
    right to training per se, even when no type or amount of training would lead to freedom.” 
    Id. at 318
     (emphasis added). In a footnote, the Court added:
    It is not feasible, as is evident from the variety of language and formulations in
    the opinions below and the various briefs here, to define or identify the type of
    training that may be required in every case. A court properly may start with the
    generalization that there is a right to minimally adequate training. The basic
    requirement of adequacy, in terms more familiar to courts, may be stated as that
    training which is reasonable in light of identifiable liberty interests and the
    circumstances of the case.
    
    Id.
     at 319 n.25.
    Having concluded that the plaintiff in Youngberg retained liberty interests in safety,
    freedom from bodily restraint, and minimally adequate habilitation, the Court addressed the
    question of how a court should identify possible violations of those rights. It held that whether
    Romeo’s rights had been violated “must be determined by balancing his liberty interests against
    the relevant state interests,” but that this balancing “cannot be left to the unguided discretion of a
    judge or jury.” 
    Id. at 321
    . Rather, “the proper standard for determining whether a State
    adequately has protected the rights of the involuntarily committed mentally retarded” is for a
    court to “make certain that professional judgment was in fact exercised.” 
    Id.
     (quotations
    omitted). Thus, the Court concluded, “the State [was] under a duty to provide respondent with
    40
    such training as an appropriate professional would consider reasonable to ensure his safety and
    to facilitate his ability to function free from bodily restraints.” 
    Id. at 324
    .
    In a concurring opinion, Justice Blackmun, joined by Justices Brennan and O’Connor,
    noted that the majority opinion “properly leaves unresolved” “whether respondent has an
    independent constitutional claim, grounded in the Due Process Clause of the Fourteenth
    Amendment, to that ‘habilitation’ or training necessary to preserve those basic self-care skills he
    possessed when he first entered” the state institution. 
    Id. at 325, 327
    . Justice Blackmun opined
    that “it would be consistent with the Court’s reasoning today to include within the minimally
    adequate training required by the Constitution such training as is reasonably necessary to prevent
    a person’s pre-existing self-care skills from deteriorating because of his commitment.” 
    Id. at 327
     (quotation and citation omitted). As explained by Justice Blackmun,
    If a person could demonstrate that he entered a state institution with minimal self-
    care skills, but lost those skills after commitment because of the State’s
    unreasonable refusal to provide him training, then, it seems to me, he has alleged
    a loss of liberty quite distinct from – and as serious as – the loss of safety and
    freedom from unreasonable restraints. For many mentally retarded people, the
    difference between the capacity to do things for themselves within an institution
    and total dependence on the institution for all of their needs is as much liberty as
    they ever will know.
    
    Id. at 327
    .
    Thus, contrary to defendants’ suggestion, there is absolutely nothing in the Supreme
    Court’s decision in Youngberg that overrules the 1978 Consent Order and the subsequent orders
    that were entered both before and after Youngberg regarding plaintiffs’ constitutional right “to
    receive habilitative care and treatment in the alternative least restrictive of individual liberty” or
    the definition of what that right means. Indeed, the Court in Youngberg expressly stated that it
    was not answering the “difficult question whether a mentally retarded person, involuntarily
    41
    committed to a state institution, has some general constitutional right to training per se.” 
    Id. at 318
    .
    2.      Post-Youngberg Cases
    In the almost 30 years since Youngberg was decided, the Supreme Court has not revisited
    the daunting task of explicating the constitutional rights of the involuntarily-committed
    developmentally disabled, and the United States Court of Appeals for the District of Columbia
    Circuit has not had the occasion to ever address this issue. Thus, there is no controlling
    precedent, other than Youngberg, and there is no consensus among the courts regarding
    defendants’ proposed interpretation of Youngberg. On the contrary, courts and judges have
    reached differing conclusions about Youngberg’s scope.
    For example, in Clark v. Cohen, 
    794 F.2d 79
     (3d Cir. 1986), the court held that plaintiff’s
    rights were violated where she was confined at an institution “in the face of unanimous
    professional opinion that she should be placed in a far less restrictive environment . . . .” Id at
    87. In a concurring opinion, Judge Edward Becker elaborated on his view of the scope of the
    constitutional right to habilitation,26 which he believed Youngberg did not address. See 
    id.
     at 92-
    98 (Becker, J., concurring). In his view, “Youngberg dealt exclusively with training related to
    physical restraints; the Court expressly stated that it was neither considering nor ruling on any
    broader right to habilitation.” 
    Id. at 95
    . Citing Justice Blackmun’s concurrence in Youngberg,
    Judge Becker stated that he also “would endorse the non-deterioration principle,” because “[t]he
    mentally disabled cannot have meaningful autonomy, and hence meaningful liberty, without
    26
    The judge examined two possible theories of the right to habilitation – quid pro quo and
    parens patriae – and concluded that both apply to a person who has been involuntarily
    committed. Clark, 
    794 F.2d at 95
    .
    42
    basic skills; therefore, for the state to allow disabled persons’ skills to deteriorate is as sure a
    denial of their liberty as is their confinement to an institution.” 
    Id. at 96
    . He then went further
    than Justice Blackmun, endorsing what he called a “[m]odified non-deterioration principle”:
    the State should be required to provide such a person with at least as much
    training as would match the improvement that he or she would have experienced
    if never committed. The reasoning behind this position is analogous to the
    reasoning supporting the non-deterioration principle: by committing people and
    preventing them from developing self-care skills, the state is effectively depriving
    them of the opportunity to develop and exercise their autonomy. This is a
    deprivation of their due process right to liberty. . . . [Thus,] involuntarily civilly
    committed persons have a right to treatment sufficient to develop their self-care
    skills to at least the level at which they would be if the persons had not been
    institutionalized.
    
    794 F.2d at 96
    . As he explained:
    Because [the plaintiff’s] institutionalization has led to her debilitation, the modified
    non-deterioration principle requires the state to provide [her] . . . with training and
    treatment sufficient to put her in the position in which she would have been had she
    never been institutionalized. Because it appears from the numerous, uncontradicted
    doctors’ reports in the record that placement in a [community living arrangement]
    is the only or best way for [her] to receive the training she is due, I believe she has
    a right to placement in the [community living arrangement], until she has acquired
    the skills she would have had had she never been institutionalized.
    
    Id. at 97
    . Finally, and significantly, Judge Becker’s opinion left open “the question whether the
    involuntarily civilly committed have a right to even greater habilitation than the modified non-
    deterioration principle would allow.” 
    Id. at 98
    . For example, as noted in the concurring opinion,
    [i]t might be argued . . . under the theories discussed here or some other theory of
    habilitation, that the involuntarily civilly committed have a right to as much
    habilitation as their capacity will allow. Alternatively, one might argue that all
    involuntarily civilly committed persons are entitled to treatment up to an absolute
    level, regardless of their status upon entrance to the institution.
    
    Id. at 98
     (emphasis added). Thus, according to this circuit judge, Youngberg is merely the
    starting point for defining the constitutional right to habilitation; it by no means precludes
    43
    recognition of additional rights for plaintiffs who, unlike the plaintiff in Youngberg, could
    benefit from more extensive habilitation.
    The court’s decision in Thomas S. v. Flaherty, 
    699 F. Supp. 1178
    , 1184 (W.D.N.C.
    1988), aff’d, 
    902 F.2d 250
     (4th Cir. 1990), is another example of a post-Youngberg case that
    endorses a broader right to habilitation than defendants advocate here.27 In Thomas S., the court
    held that the State of North Carolina was violating the constitutional rights of approximately four
    hundred mentally retarded persons who were confined in the state’s four psychiatric hospitals.
    The court approved the parties’ agreement that in terms of habilitation, “minimum professional
    standards require developmentally oriented habilitation for persons with mental retardation.” Id.
    at 1192. Such developmental habilitation requires, inter alia; “[a]dequate involvement in
    community activities,” defined as “being as involved as that individual is capable of being at the
    time”; “a good interdisciplinary evaluation” that provides an “adequate assessment of the
    individual needs of each class member”; “[p]roperly trained staff”; “[h]umane living conditions,”
    which includes more than “endless days of boredom without variation”; “treat[ment] in as
    normal a setting as possible” featuring “access to ordinary activities,” and the chance “to learn
    and grow through observing and participating in the commonplace events of daily life,”
    “developmental training and structured programs,” including “training in basic self-care skills,
    community living skills, speech therapy, and vocational services.” Id. at 1192-94. The court
    also found that “[b]ecause vocational activities are often a key to greater independence and
    enjoyment of liberty, they are for most class members an essential service to avoid unnecessary
    27
    Although the Fourth Circuit stated that it rejected the idea that class members “had a
    right to treatment in the least restrictive environment,” Thomas S., 
    902 F. 2d at 253-54
    , it also
    affirmed the district court’s order which arguably could not exist absent such a right.
    44
    restraint.” Id. at 1194. The court relied on its finding that there was “professional consensus
    that developmental, behavior-based treatment called ‘habilitation’ is the appropriate milieu for
    people with mental retardation.” Id. at 1185. Finally, the court found that habilitation “is
    defined as . . . [t]he process by which the staff of an agency assists an individual to acquire and
    maintain those life skills that enable the individual to cope more effectively with the demands of
    his or her own person and environmental and social functioning. Habilitation includes, but is not
    limited to, programs of formal structured education and treatment.” Id. at 1184 (quoting
    Accreditation Council for Services for Mentally Retarded and Other Developmentally Disabled
    Persons (1981 ed.) (quotation and citation omitted)). Not only did the court recognize a broad
    right to habilitation, it emphasized that plaintiffs were entitled both to appropriate professional
    decisionmaking and implementation of those decisions. See id. at 1185 (faulting defendants for
    not implementing community placement recommendations by treating professionals and noting
    that “[t]he record is replete with other examples of placement and treatment recommendations
    being ignored or their implementation being unjustifiably delayed”).28
    Certainly there are cases in which courts applying Youngberg have defined the right to
    habilitation more narrowly than the Court and the parties did in the 1978 Consent Order. For
    example, in Society for Good Will to Retarded Children, Inc. v. Cuomo, 
    737 F.2d 1239
     (2d Cir.
    1984), the Second Circuit held that the right to freedom from undue restraint included the right
    28
    The court in Thomas S. also found that “the conditions and services at the state
    psychiatric institutions are substantially below minimally accepted professional standard” in part
    because of “[i]nadequate treatment plans and inadequate documentation of their
    implementation.” Id. at 1197. As discussed herein, the constitutional requirement that
    professional judgment be exercised in making decisions also requires that those decisions be
    implemented. See infra pp. 61-62.
    45
    to be free from “excess locking of doors, locking of otherwise ambulatory persons into
    wheelchairs, and failing to put on leg braces for individuals who can walk with their assistance,”
    but it did not include “visiting shops, restaurants and recreational facilities in the outside
    community.” Id. at 1247. It also held that there was no “entitlement to community placement or
    a ‘least restrictive environment’ under the federal Constitution,” and that “[w]here the state does
    not provide treatment designed to improve a mentally retarded individual’s condition, it deprives
    the individual of nothing guaranteed by the Constitution; it simply fails to grant a benefit of
    optimum treatment that it is under no constitutional obligation to grant.” Id. at 1250; see also
    Lelsz v. Kavanagh, 
    807 F.2d 1243
    , 1250-51 (5th Cir. 1987) (no “right to habilitation in the least
    restrictive environment” because “[t]he constitutional minimum standard of habilitation . . .
    relate[s], not to the qualitative betterment of a retarded person’s life, but only to the training
    necessary to afford him safety and freedom from bodily restraint”); Phillips v. Thompson, 
    715 F.2d 365
    , 368 (7th Cir. 1983) (“With respect to training, Youngberg teaches that, at the most, the
    class members were entitled to minimally adequate training as is reasonable in light of their
    interest in freedom of movement and that deference must be shown to the professional judgment
    of those directing the operation of the institution. Such training as is required, therefore, is
    training to enhance the ability of the class members to exercise their right to liberty of
    movement.”); Jackson v. Fort Stanton Hosp. & Training Sch., 
    757 F. Supp. 1243
    , 1309 (D.N.M.
    1990) (“no substantive due process right to habilitation in the least restrictive environment and
    there is no constitutional right to placement in a community setting”), rev’d in part, 
    964 F.2d 980
     (10th Cir. 1992); S.H. v. Edwards, 
    886 F.2d 292
     (11th Cir. 1989) (affirming district court’s
    denial of “plaintiffs’ claims for relief in the nature of habilitation in the least restrictive
    46
    environment in accordance with the recommendation of professional treatment staff” (quotation
    omitted)).
    And then there are cases that fall somewhere in between. For example, in Association for
    Retarded Citizens of North Dakota v. Olson, 
    561 F. Supp. 473
     (N.D. 1982), aff’d, 
    713 F.2d 1384
    (8th Cir. 1983), the court held that
    the right to freedom from undue restraint . . . imposes a standard for the court’s
    determination whether professional judgment is being exercised in the use of
    medication and physical means to restrain residents. This right obligates the state
    to provide capable retarded residents with reasonable opportunities to make trips
    into the outside communities. It also tests the freedoms allowed to residents, such
    as the opportunity to make small personal decisions concerning what to wear,
    what to eat, recreation, etc. This right against unreasonable restraint also
    involves the much discussed question of alternatives to institutionalization, such
    as community homes. Prior to the Youngberg decision, this court held that the
    [F]ourteenth [A]mendment secures a right to the least restrictive practicable
    alternatives to institutionalization. While the Youngberg decision does not
    directly address this specific right, the Court’s analysis indicates that it would
    reject an absolute right to the least restrictive alternatives . . . . Following this
    analysis, this court must conclude that a constitutional right to the least restrictive
    method of care or treatment exists only insofar as professional judgment
    determines that such alternatives would measurably enhance the resident’s
    enjoyment of basic liberty interests.
    Id. at 486 (emphasis added; citation omitted). As for “the right to minimally adequate training,”
    the court held that “the resident possesses a right to training only insofar as that training serves to
    enhance or further that resident’s exercise of basic liberty.” Id. at 486-87. Thus, it does not
    include “training in music or vocational skills,” but it does include “training in walking or basic
    communication . . . if the resident could benefit therefrom . . . .” Id. at 487. It also includes “a
    right to reasonable training which enables the resident to acquire or maintain minimum self-care
    skills – skills in feeding, bathing, dressing, self-control, and toilet training.” Id. (emphasis
    omitted). The court also adopted Justice Blackmun’s view that the right to training includes
    47
    training “to enable them to maintain the minimum self-care skills that they possessed when they
    entered the institution,” and based on this view, it held that the “the acquisition and maintenance
    of those skills [are] essential to the exercise of basic liberties.” Id. at 487 (emphasis added).
    Accordingly, all that can be said about the post-Youngberg cases, none of which is
    controlling precedent, is that they disagree about how narrowly Youngberg should be interpreted
    and even if interpreted narrowly, how it should be applied to everyday situations. This very lack
    of clarity dooms defendants’ suggestion that Youngberg precludes recognition of a constitutional
    right to habilitation as described in the 1978 Consent Order.
    In the end, the critical question in a Rule 60(b)(5) inquiry is whether defendants have met
    their burden to show that Youngberg was a “significant change” in the law. They have not.
    There is language in Youngberg that arguably contradicts defendants’ reading of the case; there
    is no subsequent Supreme Court decision or post-Youngberg decision from our circuit court
    regarding the meaning of Youngberg; and among those that have addressed it, there is no
    agreement. In the face of disagreement about what the law is and no controlling precedent, the
    mere fact that some courts have adopted the interpretation defendants propose here is not
    sufficient to meet that burden. Moreover, as explained herein, defendants’ position that
    Youngberg is a significant change in law is seriously undermined by the fact that for almost 28
    years they have accepted the constitutional standard in the 1978 Consent Order and promised to
    achieve compliance with court orders based on that standard.
    48
    B.      Defendants’ Argument Regarding Youngberg Was Not Made Within a
    Reasonable Time
    Defendants concede that if Youngberg is not treated as a significant change in law, their
    motion to vacate must fail.29 But even if the Court agreed with defendants that Youngberg
    represented a significant change in the law, that does not ensure success under Rule 60(b)(5).30
    See Rufo, 
    502 U.S. at 384
    . It remains for the Court to decide whether modification in light of
    that change is warranted. See 
    id. at 391
    . Given the particular (and probably unique) facts of this
    case, the Court does not believe that the relief sought by defendants is warranted.
    Rule 60(b)(5) requires that a motion for modification be made within “a reasonable
    time.” Fed. R. Civ. P. 60(b)(5). “[W]hat constitutes ‘reasonable time’ for a filing under Rule
    60(b) depends on the facts of each case.” Ingram v. Merrill Lynch, Pierce, Fenner & Smith, Inc.,
    
    371 F.3d 950
    , 952 (7th Cir. 2004); see also McCorvey v. Hill, 
    385 F.3d 846
    , 849 n.4 (5th Cir.
    2004); Fed. Land Bank of St. Louis v. Cupples Bros., 
    889 F.2d 764
    , 767 (8th Cir. 1989). Factors
    to consider include “the length of the delay, the explanations for the delay, the prejudice to the
    opposing party caused by the delay and the circumstances warranting relief.” Associated
    Builders & Contractors v. Mich. Dep’t of Labor, 
    543 F.3d 275
     (6th Cir. 2008); see also
    Shakman v. City of Chicago, 
    426 F.3d 925
     (7th Cir. 2005) (relevant factors include “the litigants’
    29
    At oral argument, the Court asked defense counsel: “If I say the ‘78 [order] is a correct
    statement and that the subsequent orders incorporate and flow from [it], what happens then? End
    of my analysis?” Defendants’ counsel replied: “I think it is the end of your analysis, Your
    Honor.” (12/17/09 Tr. at 49.)
    30
    As discussed infra, defendants also ignore the fact that even if the Court accepts their
    Youngberg argument, it would justify, at most, partial modification of some court orders
    pertaining to plaintiffs’ right to habilitation and would have no impact on those portions of the
    orders, arguably the most critical provisions, which address plaintiffs’ constitutional rights to
    safety and health care. (See infra pp. 54-58.)
    49
    knowledge of the grounds for relief,” “the interest in finality, the reason for delay, the practical
    ability of the litigant to learn earlier of the grounds relied upon, and [the consideration of]
    prejudice [if any] to other parties” (quotations omitted)). Even applying the flexible approach a
    court must take in considering a Rule 60(b)(5) motion in institutional reform litigation, see
    Horne, 129 S. Ct. at 2594-95; Rufo, 
    502 U.S. at 381
    , defendants’ Youngberg argument comes
    decades too late, long after the entry of countless remedial court orders, many of which
    defendant agreed to and all of which were relied upon these many years by the Court, the Special
    Masters, the plaintiffs and the Department of Justice.
    The Supreme Court decided Youngberg in 1982, almost 30 years ago. Defendants could
    have sought modification of the 1978 Consent Order at any time thereafter based on the same
    argument they make today – that Youngberg effectively overruled parts of this Court’s 1978
    consent decree, thereby requiring modification of that decree. And if there was any question that
    a change in law could provide the basis for modification of a consent decree, that question was
    answered in 1992 by Rufo. 
    502 U.S. at 393
    . Indeed, there have been a number of cases in the
    intervening years, which defendants rely upon, where parties have sought and courts have agreed
    that modifications or vacatur based on a change in law was appropriate. See, e.g., Sweeton, 
    27 F.3d at 1164-65
    ; Evans, 
    10 F.3d at 480, 482-83
    ; Briley, 
    511 F. Supp. 2d at 927
    .31
    Nor is this a case where defendants can justify the delay by claiming that they were
    “unaware” of the existence of the decree or its impact. Cf. Briley, 
    511 F. Supp. 2d at 912
    (“Municipal entities, . . . however, do not have perfect institutional memory, and where a consent
    31
    Significantly, defendants cannot justify their delay by arguing that Horne is the change
    in law that they are relying on. In fact, defendants filed their motion even before Horne was
    decided on June 25, 2009.
    50
    decree has gone unenforced for many years, the individuals who administer those entities may
    not have any knowledge of its existence.”). To the contrary, defendants have been in Court
    continually and repeatedly since the 1978 Consent Order defending against plaintiffs’ charges of
    noncompliance, and when their efforts failed for good reason, numerous substantive court orders
    resulted.32
    The only reason defendants give for their 27-year delay in making their Youngberg
    argument is that they only just realized that the 1978 Consent Order was based on a
    “misunderstanding of the governing law.” (See 12/17/09 Tr. at 8.) Even assuming such a
    “mistake” could ever justify a delay of this magnitude, it does not do so here. Defendants cannot
    make a plausible argument that they, along with everyone else involved in this case, have been
    operating under a misguided view of the law and only now, with the arrival of a new Attorney
    General, has the law become clear. (See 12/17/09 Tr. at 19.) Not only did it take 27 years for
    defendants to realize their purported mistake, during that period, they entered into a number of
    additional consent orders and agreements that were designed to achieve the constitutional
    standards enunciated in the 1978 Consent Order. (See 1983 Consent Order; 1995 Reference
    Order; 2001 Joint Findings of Fact; 2001 Plan; 2001 Consent Order; 2007 90-Day Consent
    Order.) For example, in 1995 defendants “admit[ted] that the District has a continuing
    responsibility to provide the class members with habilitation in accordance with their needs” and
    32
    (See, e.g., 1981 Consent Order; 1983 Consent Order; Jan. 1990 Contempt Order; Apr.
    1990 Contempt Order; Order Denying Motion for Civil Contempt Sanctions, May 15, 1991;
    1995 Contempt Order; 1996 Order & Remedial Plan; 2001 Joint Findings of Fact, Consent
    Order, Plan for Compliance; 2004 Coordination Order; 2007 Order and Opinion on Liability;
    2007 90-Day Consent Order; 2008 Special Masters’ Report re 90-Day Consent Order; 2009
    Special Masters’ Report.)
    51
    “admit[ted] that they also are required to provide adequate medical care, psychological care, day
    programming, community residential placements and other support systems as set forth in the
    class members’ [individual habilitation plans].” (1995 Contempt Order at 5-6.) And as recently
    as September 2007, the current administration under Mayor Fenty agreed to take a number of
    specific actions, including “recruiting five new providers” and ensuring that the residences
    operated by these providers, inter alia, “are located close to shops, restaurants, community
    resources and public transportation, or there is transportation available to class members in order
    to access these resources” – an obligation that clearly flows from the parts of the 1978 Consent
    Order the District now contends are “extraconstitutional.” (2007 90-Day Order at 2.) Moreover,
    the Court’s March 2007 Liability Opinion and the 2009 Special Masters’ Report are replete with
    references to a legal standard that only now does the District find convenient to repudiate.
    “Modification of a consent decree may be warranted when changed factual conditions make
    compliance with the decree substantially more onerous,” Rufo, 
    502 U.S. at 384
    , but not simply
    because “it is no longer convenient to live with the terms of a consent decree.” 
    Id. at 383
    .
    Finally, and perhaps most importantly, defendants’ actions over the past 30 years – their
    repeated representations, promises and agreements – have led the Court and the plaintiffs to
    believe that defendants had every intention of complying with the existing orders. For example,
    in asking the Court in February 2007 to delay its liability ruling, the District stated that it was
    “cognizant that much remains to be done to bring DDS into compliance with outstanding court
    orders and the 2001 Plan,” but assured the Court that the “Fenty Administration is fully
    committed to the success of the new agency, the delivery of improved services and care to the
    consumers served by the agency, and compliance with the 2001 Plan.” (Defs.’ Notice of Filing
    52
    of Supplemental Info. in Resp. to the Court Monitor’s Quarterly Report at 8, Feb. 5, 2007
    (emphasis added).) Again, in May 2008, Peter Nickles, the Attorney General for the District,
    assured the Court “I am not seeking . . . to take away what [the plaintiffs] won.” (Hr’g Tr. at 37,
    May 15, 2008.) But that is exactly what the District seeks to do.
    Everyone, including the three judges of this Court, who has struggled with this case for
    over 30 years has relied on defendants’ repeated promises that they intended to comply.
    Plaintiffs have repeatedly entered into new agreements with defendants. (See, e.g., 1981
    Consent Decree, 1983 Consent Decree; 2001 Consent Order; 2001 Plan; 2007 90-Day Consent
    Order.) Plaintiff have also withdrawn motions to find defendants in noncompliance or in
    contempt that they might otherwise have successfully pursued. (See, e.g., 1983 Consent Order at
    14 (withdrawing motion for contempt); Evans, 139 F. Supp. 2d at 84 (waiving “all claims for
    past contumacious conduct of defendants as of the date of the entry of the [2001] Consent Order
    and approval of the Settlement Agreement”).)
    Moreover, the Court has on numerous occasions endorsed agreements between the
    parties and adopted them as court orders. (See, e.g., 1981 Consent Decree, 1983 Consent
    Decree; 2001 Consent Order; 2001 Plan; 2001 Joint Findings of Fact; 2007 90-Day Order.)
    Judge Stanley Harris’s reliance on defendants’ stated intention to achieve compliance with
    existing court orders is especially apparent in his 2001 opinion, wherein he notes that “[t]he
    dispute seemed intractable until last year, towards the end of which there were commendable and
    extensive efforts by Mrs. Farrell, Mr. Sundram, and counsel for the parties seeking to resolve the
    problems faced by all.” Evans, 139 F. Supp. 2d at 85. The Court commended the Special
    Masters and counsel not only for “resolving their differences, but for the exceptionally thorough
    53
    manner in which they have agreed upon procedures for dealing with the problems that have
    persisted for so long” and explained that it approved the Plan and adopted the parties’ consent
    order and settlement agreement because it “readily conclude[d] that the proposed compromise of
    the controversy, which will be of substantially greater benefit to the class than would continued
    litigation over how to deal with past conduct by defendants, is fair, reasonable, and adequate.”
    Id.; (see also 1995 Contempt Order at 1 (emphasizing that “[a]n integral part of this litigation has
    been the closure of Forest Haven and the relocation of class members to community living
    arrangements with adequate habilitation suitable to each class member” and “[t]o this end, the
    Court has entered numerous orders, including consent orders between the parties, to safeguard
    the rights of class members and ensure their adequate and appropriate habilitation.”).)
    In sum, no factor supports a finding that defendants have filed their Rule 60(b)(5)
    motion, to the extent it is based Youngberg, within a “reasonable time.” Defendants have no
    excuse for their delay; they have repeatedly consented to the constitutional standard as stated in
    the 1978 Consent Order; they successfully convinced the plaintiffs and the Court on numerous
    occasions that they intended to comply with the court orders; and the vulnerable class members,
    their counsel, the Department of Justice and three judges of this Court have relied to their
    detriment on the District’s endless promises.
    C.      At Most, Defendants’ View of Youngberg Supports Only a Limited
    Modification of the Consent Orders
    Even if defendants could argue that Youngberg was a significant change in the law
    (which they cannot), that argument would support nothing more than a limited modification of
    the consent orders. In the first place, even if Youngberg changed the law with respect to the
    scope of the constitutional right to habilitation, that would not undermine the legal basis for the
    54
    host of provisions in the court orders and the 2001 Plan that relate solely to health care and
    safety. See Youngberg, 
    457 U.S. at 315-16
     (not disputed that plaintiff had “a right to adequate
    food, shelter, clothing, and medical care” and Court held that right to safe conditions and right to
    freedom from bodily restraint were the “core of the liberty protected by the Due Process
    Clause”). Requirements relating to these rights (as opposed to habilitation) are a substantial part
    of the challenged court orders and the 2001 Plan. (See 1978 Consent Order; Evans, 
    459 F. Supp. at 484, 488-89
    ; 1981 Consent Order at 6-7; 1983 Consent Order at 4-8; 2001 Consent Order;
    2001 Plan; 2007 90-Day Consent Order.) Moreover, these provisions are arguably the most
    critical and cover areas where defendants have been most deficient. Certainly, in recent years,
    health and safety have been the primary focus and concern of the Court, the Special Masters, the
    Court Monitor and the parties. See Evans, 
    480 F. Supp. 2d at 298-314
     (factual findings in March
    2007 Liability Opinion regarding health and safety); (2007 90-Day Order (addressing two
    critical goals: increasing the number of qualified providers and improving the health and safety
    of class members); 2009 Special Masters’ Report at 18-67 (findings and conclusions of law
    regarding health care, mental and behavioral health care, guardianship, safety and protection
    from harm); Court Monitor’s Report, June 11, 2009; and Court Monitor’s Report, Dec. 10,
    2009.)
    For example, according to the 2001 Plan, the crux of plaintiffs’ right to be kept free from
    harm is addressed by six specific directives in the 1978 Consent Order and the 1983 Consent
    Order. (2001 Plan at 27-28). These directives
    require conducting timely and thorough investigations into serious incidents,
    including deaths; identifying causes and contributory factors as well as preventive
    and corrective actions that appear to be warranted; and ensuring the
    implementation of recommendations that are made as a result of the
    55
    investigations. In addition to responding to individual cases, the defendants are
    required to identify systemic patterns and trends and communicate them to
    providers to facilitate corrective action for recurrent problems on an individual
    consumer level, provider level and a systemic level. . . . [and to] ensure that
    appropriate training programs for all staff, including staff assigned to residential
    settings are developed and implemented.
    (2009 Special Masters’ Report at 50.) In March 2007, this Court found “defendants ha[d] failed
    in many significant respects to accomplish the tasks and outcome criteria associated with the
    Court’s Orders relating to class member safety and to comply with the terms of the Orders
    themselves.” Evans, 
    480 F. Supp. 2d at 313
    . In late November 2007, defendants conceded that
    as of yet, conditions had not fundamentally changed. (Def.’s Notice Concerning Proposed
    Comprehensive Monitoring at 2.) And, as of December 2008, the Special Masters found that
    “there is clear and convincing evidence that the problems being experienced by class members in
    the area of safety and protection from harm are continuing, serious and systemic.” (2009 Special
    Masters’ Report at 67). Thus, no matter how Youngberg is interpreted, it would not excuse
    defendants from these obligations.
    Moreover, even if defendants’ overly narrow interpretation of Youngberg were to be
    adopted, it would only entitle defendants to partial modification of the court orders concerning
    habilitation. For example, as the 2007 Liability Opinion makes clear, the right to receive
    habilitative care and treatment in the alternative least restrictive of individual liberty, see Evans,
    
    480 F. Supp. 2d at 314-19
    , is only one aspect of plaintiffs’ right to habilitation/welfare.
    Plaintiffs are also entitled to “a written ISP based upon individualized assessments and
    formulated in accordance with professional standards”; “an individualized habilitation program
    designed in accordance with the ISP”; identification in the ISP of “all services and supports
    required by class members regardless of availability”; annual review of the ISP; “adaptive
    56
    equipment” if needed; “enough case manager positions to meet the required case manager to
    client ratio”; “appropriate training programs for staff, including case managers”; and case
    managers who ensure implementation of ISPs and take appropriate action after incidents. See id
    at 319, 321-22; (see also 2009 Special Masters’ Report at 67-75 (same)). Similarly, in the six-
    page, single-spaced 2007 90-Day Consent Order (which defendants agreed to after the Fenty
    administration took office), the only provision arguably affected by Youngberg would be the
    requirement that defendants ensure that residences operated by new providers “are located close
    to shops, restaurants, community resources and public transportation, or there is transportation
    available to class members in order to access these resources.” (2007 90-Day Consent Order at
    2.)
    Finally, one of defendants’ primary points about Youngberg is that it rejects any right to
    community placement, but the present record establishes that plaintiffs failed to prove that
    defendants are in noncompliance with the 2001 Plan with respect to moving a significant number
    of class members into group homes. (See 2009 Special Masters’ Report at 72.)33 For those class
    33
    As described in the 2009 Special Masters’ Report:
    The unchallenged testimony of defendants’ witness, Laura Nuss, is that there have
    been 250 placements into less restrictive environments. Defendants have moved
    a significant number of class members to apartments and group homes. The
    evidence during the liability phase of this action was that 55% of class members
    resided in ICFs/MR (366 of 659 class members, 480 F. Supp 2d at 315 n.43.)
    That number is down to a little over 250 class members (approximately 40% of
    the class), and defendants reasonably expect to accelerate that movement with the
    further development of the community-based waiver and the Money Follows The
    Person Grant, which is expected to further reduce the utilization of ICFs/MR by
    60% (Nuss Trial Tr. 275:18-21). Based on these findings of fact, the Special
    Masters find that plaintiffs have not sustained their burden of proving by clear
    and convincing evidence non-compliance with court orders requiring residential
    placements in less restrictive settings.
    57
    members who continue to reside in ICF/MR settings, the Report noted that “there was no
    evidence submitted to establish that continued placement of all or some subset of these class
    members in such settings was improper or contrary to a choice made by the class member or an
    authorized surrogate decision-maker.” (Id. at 73.)
    In the end, then, defendants’ argument that Youngberg changed the law on habilitation
    would, at most, require partial modification of a limited number of court orders concerning
    habilitation; it would not affect the legitimacy of any other order, including many critical orders,
    concerning plaintiffs’ health, welfare and safety. But defendants do not seek such a limited
    modification; rather they make an “all or nothing” argument for vacatur.34
    (Id. at 72.)
    34
    (See 12/17/2009 Tr. at 22 (“Your Honor, I do not think there is a middle ground.”); id at
    24 (“modification as to the plan would be something that would almost be a futile act”).) In
    defendants’ brief, they state that if the Court rejects this option, “[i]n the alternative, the Court
    should at the very least modify the orders currently in force, to eliminate any provisions that are
    not reasonably necessary to remedy a current and ongoing constitutional violation.” (Defs.’
    Mem. at 7.) However, if defendants want a modification, it is their burden to show the Court
    that the modification is narrowly tailored to the change in circumstances. Rufo, 
    502 U.S. at 383
    (“[A] party seeking modification of a consent decree bears the burden of establishing that a
    significant change in circumstances warrants revision of the decree. If the moving party meets
    this standard, the court should consider whether the proposed modification is suitably tailored to
    the changed circumstance.”). Defendants have made no effort to offer a modification suitably
    tailored to the arguably changed circumstances. (See 12/17/09 Tr. at 39 (“Your Honor, in all
    candor, if you do not vacate the orders, we would have to look at them anew and see if any – if –
    what modifications could be made to them that are realistic.”)); see also See LaShawn v. Fenty,
    No. 89-CV-1754, 
    2010 WL 1270202
    , at *21 (D.D.C. Apr. 5, 2010) (defendants similarly did not
    “propose[] a modification tailored to the alleged changed circumstances” leaving the court
    without “an adequate proposal to consider”). Moreover, they have steadfastly refused to invoke
    the procedures provided for by the 2001 Plan (see 2001 Plan at 6-10) or under Rule 60(b)(5) for
    modification or termination of orders that have been achieved or those that are no longer relevant
    or obtainable.
    58
    II.    DEFENDANTS ARE NOT ENTITLED TO VACATUR BASED ON CHANGE IN
    FACTS
    A.      Defendants Are Not in Substantial Compliance with Constitutional
    Requirements
    Defendants argue that, even though they have not achieved compliance with the court
    orders or the 2001 Plan, the objects of those orders have been attained because defendants have
    satisfied the “constitutional minimum.” (Defs.’ Mem. at 32 (“District’s current system for
    serving individuals with intellectual and developmental disabilities . . . patently satisfies class
    members’ Fifth . . . Amendment rights to be free from harm and to receive minimally adequate
    habilitative care and treatment.”).) Defendants’ argument fails because (1) it rests on a flawed
    definition of the constitutional minimum; and (2) its rests on an erroneous interpretation of
    Horne as allowing properly entered consent orders to be vacated, despite defendants’ non-
    compliance with those orders, once defendants achieve the constitutional minimum.
    1.      Defendants Cannot Provide a Workable Definition of Constitutional
    Requirements Based on Youngberg
    Defendants’ argument that they have satisfied the “constitutional minimum” requires that
    that concept be defined, but defendants’ proffered definition is fundamentally flawed.
    According to defendants, Youngberg establishes as the constitutional minimum that involuntarily
    committed individuals have only the right to be kept “free from harm” and the right to
    “minimally adequate habilitation,” defined as “such training as may be reasonable in light of [the
    individual’s] liberty interests in safety and freedom from unreasonable restraints.” (Def. Mot. to
    Vacate at 16 (quotations omitted) (quoting Youngberg, 
    457 U.S. at 322
    ). Defendants then baldly
    assert that they have met this constitutional minimum because “[w]e’re exercising professional
    judgment in the care and treatment of consumers within the class. They’re free from harm. And
    59
    they’re getting sufficient training and habilitation so that their liberty interests are protected.”
    (12/17/09 Tr. at 104.)
    Although the constitutional minimum certainly includes the rights articulated in
    Youngberg, defendants’ argument that no more is required is premised on an error of law. First,
    as noted, Youngberg did not concern an involuntarily committed person’s constitutional right to
    “food, shelter, clothing, and medical care.” Youngberg, 
    457 U.S. at 315
    . It is indisputable that
    any constitutional minimum standard must include protection of these rights.35 Moreover, as
    these rights were not at issue in Youngberg, Youngberg provides no guidance as to what is
    required to meet the constitutional minimum with respect to the protection of these rights.
    In addition, to the extent defendants contend that the constitutional minimum is met as
    long as there is a system in place that calls for the exercise of professional judgment (see
    12/17/09 Tr. at 103;36 Defs.’ Mem. at 33 (“no credible argument can be made that there is a
    systemic lack of professional judgment exercised by treating professionals in the IDD system”)),
    35
    When asked to explain what a minimal right to medical care encompasses, defense
    counsel suggested that plaintiffs’ right to medical care was limited to the “health implications” of
    the “very minimal” “duty to keep them safe and free from unreasonable restraints.” (12/17/09
    Tr. at 100.) As an example of what might be covered, defense counsel suggested “if a person
    needs certain treatment so that they can be free from unreasonable restraints, yes, that is part of
    what Youngberg dictates.” (Id.) Or, if a person has a tumor, there may be a some duty to act if
    the person “may not be safe, depending on the invasiveness of the tumor.” (Id. at 101.) Not only
    is it incomprehensible that an involuntarily committed developmentally disabled person is not
    entitled to more than counsel’s meaningless and inadequate level of care, but counsel’s inability
    to provide any workable definition illustrates the inherent difficulty prescribing in the abstract
    what services are required so that a constitutionally protected right will be something more than
    a hollow promise.
    36
    During oral argument, the Court asked defense counsel whether it mattered if “the
    healthcare provider’s recommendations as to the class members are not implemented in a timely
    manner,” to which counsel responded, “I don’t think Youngberg speaks to the timeliness of the
    matter.” (12/17/09 Tr. at 103.)
    60
    that proposition is not supported by Youngberg. Youngberg expressly states that a court must
    “make certain that professional judgment in fact was exercised” in attempting to protect the
    rights of an involuntarily committed individual. 
    457 U.S. at 321
     (emphasis added) (quotation
    omitted). As other courts have recognized, in order for this requirement to have any substance, it
    cannot be met purely at the systemic level; rather, professional judgments must be implemented
    in a timely fashion. See, e.g., Thomas S., 
    902 F.2d at 252
     (holding that district court properly
    imposed liability because it “found that many of the decisions of the treating professionals had
    not been implemented” and “found areas in which the decisions of the treating professional
    substantially departed from accepted standards”); Haldeman v. Pennhurst, 
    901 F.2d 311
    , 324 (3d
    Cir. 1990) (“obligations [under the consent decree] clearly run to class members as individuals,
    not as a group” and thus “substantial compliance must be measured with respect to the services
    each individual retarded class member is receiving and not with respect to the services received
    by the class as a whole”).
    Finally, defendants again ignore, as discussed above, that Youngberg did not address the
    right to habilitation generally; it decided only that the plaintiff, who was profoundly retarded and
    would not benefit from any other habilitation, was entitled to the limited habilitation he sought –
    such training as may be reasonable in light of his liberty interests in safety and freedom from
    unreasonable restraints. See Youngberg, 
    457 U.S. at 318
     (because plaintiff “seeks only training
    related to safety and freedom from restraints, this case does not present the difficult question
    whether a mentally retarded person, involuntarily committed to a state institution, has some
    general constitutional right to training per se” (emphasis added)). For all these reasons, the
    rights recognized by Youngberg are necessary, but not sufficient, to give meaning to plaintiffs’
    61
    basic constitutional rights.
    2.      Even If Defendants Have Satisfied Minimum Constitutional
    Requirements, This Does Not Justify Vacatur Under Horne
    The second problem for defendants is that they cannot seek vacatur of all court orders
    based on Horne. In Horne, the district court concluded, after a trial, that the State of Arizona
    was violating the requirement in the Equal Educational Opportunities Act (“EEOA”) “to take
    appropriate action to overcome language barriers that impede equal participation by its students
    in its instructional programs,” 
    20 U.S.C. § 1703
    (f), because “the amount of funding the State
    allocated for the special needs of ELL students . . . was arbitrary and not related to the actual
    funding needed to cover the costs of ELL instruction.” Horne, 129 S. Ct. at 2589. Pursuant to
    this judgment, the court ordered the State, inter alia, to “prepare a cost study to establish the
    proper appropriation to effectively implement ELL programs,” “to provide funding that bears a
    rational relationship to the actual funding needed,” and to “appropriately and constitutionally
    fund” the ELL program. Id. at 2590 (quotations and citations omitted).
    The defendants never complied with any of the court’s orders, but in 2006 the State
    Legislature passed a new law that “increased ELL incremental funding [by a fixed amount] (with
    a 2-year per-student limit on such funding) and created two new funds – a structured English
    immersion fund and a compensatory instruction fund – to cover additional costs of ELL
    programming.” Id. at 2590. Based on this new legislation, the state legislature asked the district
    court to vacate its orders. The district court concluded that Rule 60(b)(5) relief was not
    warranted because the new law “did not establish a funding system that rationally relates funding
    available to the actual costs of all elements of ELL instruction.” Id. at 2591 (quotations
    omitted). The Ninth Circuit affirmed, emphasizing that because the original declaratory
    62
    judgment order centered on the adequacy of ELL incremental funding, relief would be
    appropriate only if “there are no longer incremental costs associated with ELL programs in
    Arizona,” or if “Arizona had altered its funding model.” Id. at 2591-92 (quotations omitted).
    The Supreme Court reversed and remanded, holding that the lower courts had erred by
    looking only to whether the State was fulfilling the specific terms of the judgment instead of
    considering whether “Arizona is now fulfilling its statutory obligation by new means that reflect
    new policy insights and other changed circumstances.” Id. at 2589. The Court remanded the
    case with instructions to consider “whether the objective of the District Court’s 2000 declaratory
    judgment order – i.e. satisfaction of the EEOA’s appropriate action standard – has been
    achieved.” Horne, 129 S. Ct. at 2595 (quotations omitted).
    Under Horne and earlier Supreme Court decisions, a motion to vacate, such as defendants
    have filed here, requires the Court to determine whether the “objective” of the court orders has
    been attained. Id.; Frew, 
    540 U.S. at 442
     (“The federal court must exercise its equitable powers
    to ensure that when the objects of the decree have been attained, responsibility for discharging
    the State’s obligations is returned promptly to the State and its officials.”); see also LaShawn,
    
    2010 WL 1270202
    , at *11 (in addressing motion to vacate consent decree, “it is appropriate to
    consider whether the objectives of the decree have been achieved”).
    Defendants attempt, nevertheless, to read Horne as a new rule of law that equates
    satisfying the constitutional minimum with attaining the objective of a consent decree. (See
    Defs.’ Mem. at 18 (no ongoing constitutional violations because the “current IDD system
    administered by DDS/DDA . . . not only satisfies but greatly surpasses the minimum
    constitutional standards established by the Fifth Amendment.” ); 12/17/09 Tr. at 10-11, 13, 16,
    63
    42, 48.) This Court cannot accept this exceedingly broad interpretation of Horne, for Horne
    cannot mean that when a defendant agrees to a series of measures designed to remedy
    constitutional violations, these agreements are necessarily unenforceable because the measures
    exceed some ill-defined constitutional floor.
    Unlike Horne, the present case involves a consent decree, not a litigated judgment. A
    consent decree “‘embodies an agreement of the parties’ and is also ‘an agreement that the parties
    desire and expect will be reflected in, and be enforceable as, a judicial decree that is subject to
    the rules generally applicable to other judgments and decrees.’” Frew, 
    540 U.S. at 437
     (quoting
    Rufo, 
    502 U.S. at 378
    ). “[A] federal consent decree must spring from, and serve to resolve, a
    dispute within the court’s subject-matter jurisdiction; must come within the general scope of the
    case made by the pleadings; and must further the objectives of the law upon which the complaint
    was based.” 
    Id.
     (citing Firefighters, 478 U.S. at 525). “Consent decrees entered in federal court
    must be directed to protecting federal interests.” Id.; see also LaShawn, 
    2010 WL 1270202
    , at
    *13.
    The decision in Horne was obviously motivated by the perceived dangers of long-term
    judicial involvement in local government institutions, noting that “Rule 60(b)(5) serves a
    particularly important function in . . . ‘institutional reform litigation’” because “injunctions
    issued in such cases often remain in force for many years, and the passage of time frequently
    brings about changed circumstances – changes . . . in governing law . . . and new policy insights
    – that warrant reexamination of the original judgment.” Horne, 129 S. Ct. at 2593. The Court
    in Horne also noted that “institutional reform injunctions often raise sensitive federalism
    concerns,” particularly where they “involve[] areas of core state responsibility” or “ha[ve] the
    64
    effect of dictating state or local budget priorities.” Id. at 2593-94. And in dicta it suggests that
    these problems are exacerbated in cases governed by consent decrees rather than litigated
    judgments because consent decrees often “go well beyond what is required” by law, and
    “thereby ‘improperly deprive future officials of their designated legislative and executive
    powers.’” Id. at 2594 (quoting Frew, 
    540 U.S. at 441
    ).
    But in Horne, the Supreme Court also endorsed and cited its prior decisions in Rufo and
    Frew – decisions approving the use of consent decrees in institutional reform cases. See Horne,
    129 S. Ct. at 2593-95; see also Salazar v. District of Columbia, No. 93-452, 
    2010 WL 547834
    , at
    *3 (D.D.C. Feb. 18, 2010) (concluding that Horne “reaffirmed the vitality of [Rufo,] 
    502 U.S. 367
    , 368 (1992), the leading case setting forth the standards for modifying a final judgment
    under Rule 60(b)(5) in institutional reform cases.”); LaShawn, 
    2010 WL 1270202
    , at *8, *12-
    *13 (applying Rufo standards).37 If, as defendants argue, there is an inherent conflict between
    Horne and Rufo or Frew, the Supreme Court certainly did not acknowledge it. Thus, this Court
    is bound by those earlier decisions, and it will not adopt defendants’ attempt to use Horne to
    undermine their holdings. See Agostini v. Felton, 
    521 U.S. 203
    , 237 (1997) (“If a precedent of
    this Court has direct application in a case, yet appears to rest on reasons rejected in some other
    line of decisions, the [lower court] should follow the case which directly controls, leaving to this
    Court the prerogative of overruling its own decisions.”).
    Significantly for purposes of the present case, Rufo and Frew establish that a consent
    decree may appropriately go beyond the bare bones of what a court could order without the local
    37
    As noted by Judge Hogan, 
    2010 WL 1270202
    , at *13, the D.C. Circuit in LaShawn
    upheld a decree even assuming that it “imposes requirements beyond those of District law.”
    LaShawn A. v. Barry, No. 94-7044, 
    1996 WL 679301
    , at *1 (D.C. Cir. Oct. 30, 1996).
    65
    government’s consent.38 See Rufo, 
    502 U.S. at 389
     (“But we have no doubt that, to ‘save
    themselves the time, expense, and inevitable risk of litigation,’ [the defendants] could settle the
    dispute over the proper remedy for the constitutional violations that had been found by
    undertaking to do more than the Constitution itself requires (almost any affirmative decree
    beyond a directive to obey the Constitution necessarily does that), but also more than what a
    court would have ordered absent the settlement.” (citation omitted)); Frew, 
    540 U.S. at 437-38
    (rejecting argument that consent decree violates the Eleventh Amendment on the that “state
    officials [may agree] to bind state governments to significantly more commitments than what
    federal law requires”); see also Local No. 93, Int’l Ass’n of Firefighters v. City of Cleveland, 
    478 U.S. 501
    , 525 (1986) (consent decree may properly “provide[] broader relief than the court could
    have awarded after a trial”). Indeed, that is one reason why consent decrees are a valuable tool
    for resolving such cases. See Rufo, 
    502 U.S. at 383
     (noting that if plaintiffs enter into a consent
    38
    Even without consent, a court may impose a remedy that goes beyond ordering
    defendants to satisfy the constitutional floor. Federal court decrees “exceed appropriate limits if
    they are aimed at eliminating a condition that does not violate the Constitution or does not flow
    from such a violation,” Milliken, 
    433 U.S. at 282
    , but “where . . . a constitutional violation has
    been found, the remedy does not ‘exceed’ the violation if the remedy is tailored to cure the
    condition that offends the Constitution.” 
    Id.
     (quotation omitted). For example, in Milliken,
    “[t]he ‘condition’ offending the Constitution is Detroit’s de jure segregated school system, which
    was so pervasively and persistently segregated that the District Court found that the need for the
    educational components flowed directly from constitutional violations by both state and local
    officials. These specific educational remedies, although normally left to the discretion of the
    elected school board and professional educators, were deemed necessary to restore the victims of
    discriminatory conduct to the position they would have enjoyed in terms of education had these
    four components been provided in a nondiscriminatory manner in a school system free from
    pervasive de jure racial segregation.” 
    Id.
    Significantly, this same principle was adopted in Horne, where the Court recognized that
    federal court decrees are not limited to the constitutional floor in awarding relief for a violation
    of law. Rather, federal court decrees do not “exceed appropriate limits if they are aimed at
    eliminating a condition that . . . flow[s] from such a violation.” See Horne, 129 S. Ct. at 2495.
    66
    decree “[a]t least they will avoid further litigation and perhaps will negotiate a decree providing
    more than what would have been ordered without the local government’s consent”); Local No.
    93, 
    478 U.S. at 522
     (“Consent decrees are entered into by parties to a case after careful
    negotiation has produced agreement on their precise terms. The parties waive their right to
    litigate the issues involved in the case and thus save themselves the time, expense, and inevitable
    risk of litigation. Naturally, the agreement reached normally embodies a compromise; in
    exchange for the saving of cost and elimination of risk, the parties each give up something they
    might have won had they proceeded with the litigation.” (quoting United States v. Armour &
    Co., 
    402 U.S. 673
    , 681 (1971)); see also LaShawn, 
    2010 WL 1270202
    , at *12-*13.
    In addition, federal district courts retain the power to enforce consent decrees in
    institutional reform cases. A consent decree “‘embodies an agreement of the parties’ and is also
    ‘an agreement that the parties desire and expect will be reflected in, and be enforceable as, a
    judicial decree that is subject to the rules generally applicable to other judgments and decrees.’”
    See Frew, 
    540 U.S. at 437
     (quoting Rufo, 
    502 U.S. at 378
    .) “Federal courts are not reduced to
    approving consent decrees and hoping for compliance. Once entered, a consent decree may be
    enforced.” 
    Id. at 440
    .39
    39
    As noted by the Supreme Court in Local No. 93:
    Parties may choose to settle their disputes by consent decree rather than by
    private contract for a number of reasons. As one commentator points out, [p]ublic
    law settlements are often complicated documents designed to be carried out over
    a period of years, . . . so any purely out-of-court settlement would suffer the
    decisive handicap of not being subject to continuing oversight and interpretation
    by the court. . . . A consent decree has several other advantages as a means of
    settling litigation. It is easier to obtain enforcement of a consent decree because it
    will be unnecessary to prove many facts that would otherwise have to be shown in
    order to establish the validity of an ordinary contract. A court that maintains
    67
    Because Horne did not involve a consent decree, it had no occasion to address
    defendants’ claim that all they have to do is satisfy the constitutional minimum as opposed to
    provisions of a consent decree that arguably exceed the minimum but were agreed to by the
    parties to cure conditions that flow from constitutional violations. But this very claim was
    addressed and rejected in Rufo. There, the Supreme Court made clear that where there is a
    consent decree in place, the legally enforceable obligations are “not confined to meeting minimal
    constitutional requirements.” Rufo, 
    502 U.S. at 390
    . Moreover, “[a] proposed modification
    should not strive to rewrite a consent decree so that it conforms to the constitutional floor,” Rufo,
    
    502 U.S. at 391
    , and a party cannot “require a court to retrace old legal ground, say, by
    re-making or rejustifying its original ‘constitutional decision every time an effort [is] made to
    enforce or modify’” an order. Horne, 129 S. Ct. at 2619 (quoting Rufo, 
    502 U.S. at 389-390, 392
    ); see also LaShawn, 
    2010 WL 1270202
    , at *11-*13.
    Despite this binding precedent, defendants cite to a number of cases decided since Horne
    where courts have vacated consent decrees. (See Defs.’ Reply at 6 & n.9; Defs.’ Notice of
    Supplemental Authority, Dec. 9, 2009; Defs.’ Notice of Supplemental Authority, Mar. 30, 2010).
    However, none of the cited cases is analogous to our case, for, in each of them, there were
    compelling circumstances that supported the termination of the consent decree that are not
    continuing jurisdiction over a consent decree will have a more flexible repertoire
    of enforcement measures. And it is likely to be easier to channel litigation
    concerning the validity and implications of a consent decree into a single
    forum-the court that entered the decree-thus avoiding the waste of resources and
    the risk of inconsistent or conflicting obligations. . . . For all of these reasons,
    consent decrees have become widely used as devices to facilitate settlement.
    
    478 U.S. at
    524 n.13 (quotations and citations omitted).
    68
    present here.
    In three of the four cases, defendants were found to be in full compliance with the
    consent decree. In United States v. Board of Education of the City of Chicago, 
    663 F. Supp. 2d 649
     (N.D. Ill. 2009), the district court terminated a consent decree that addressed segregation in
    the Chicago school system based on its determination that defendants had complied in good faith
    with the consent decree and court orders over a reasonable period of time, had eliminated all
    vestiges of segregation to the extent practicable, and had demonstrated its good faith
    commitment to the constitutional rights that were the predicate for intervention. 
    Id. at 654
    , 660-
    62. Similarly, in Consumer Advisory Board v. Harvey, No. 91-CV-321-P-S, 
    2010 WL 1037593
    (D. Me. Mar 19, 2010), defendants had “achieved substantial compliance” with the consent
    decree by meeting the benchmarks set forth in the decree itself. Id. at *3.40 Finally, in Basel v.
    Bielaczyz, No. 74-40135-BC, 
    2009 WL 2843906
     (E.D. Mich. Sept. 1, 2009), the court vacated a
    consent judgment that was entered to correct the substantial backlog of hearing requests before a
    state agency after noting that “[i]n the years closely following entry of the consent judgment,
    there is no suggestion on the docket or by the parties that Defendants were ever held in contempt
    based on a failure to comply with the consent judgment. . . . The terms of the consent judgment
    and the history of apparent compliance suggest that the consent judgment served its purpose, and
    at some point, the need for the injunction passed .” Id. at *7.
    In contrast, defendants here have a proven 30-year history of noncompliance. And, in
    40
    Notably, Clarence Sundram was the Special Master in Harvey, which had a similar
    factual history to our case. One key difference, though, is that in his final report to the district
    court, Special Master Sundram concluded that the defendants were in compliance and the time
    was ripe for a Rule 60(b)(5) motion to vacate the consent decree. See Final Report of the Special
    Master, Harvey, 
    2009 WL 5792159
    , at *11-*12.
    69
    fact, based on the representations of defense counsel at oral argument, there is a serious question
    as to whether defendants are even trying to comply with these orders.41
    The fourth post-Horne case cited by defendants is also inapposite. In Cleveland Fire
    Fighters for Fair Hiring Practices v City of Cleveland, No. 1:00-CV-301, 
    2009 WL 2602366
    (N.D. Ohio Aug. 20, 2009), the district court denied a Rule 60(b)(5) motion to extend the term of
    a consent decree that had been entered in 1975 to address discrimination in the hiring practices
    of the Cleveland Fire Department. Id. at *3, *16. The court declined to extend the decree
    because if found that (1) defendant City has “extended its best efforts to achieve the hiring
    goals” in the decree; (2) all parties used their best efforts to produce dynamic change; (3)
    “changes relating to, among other things, this nation’s declining economy have taken place,
    41
    As explained by defense counsel:
    MS. EFROS: I think what matters is, looking at it today, this is not something that
    this administration embraces. It is not something that this administration
    necessarily needs to embrace.
    THE COURT: It does as long as the orders exist. I’m sorry to tell you that. You
    may not like to embrace it happily, but there are Court orders out there.
    MS. EFROS: That is the purpose of our motion today.
    THE COURT: Sure.
    MS. EFROS: If you deny our motion, then we’re left with an appeal or
    conforming to the Court order. But the very purpose of our motion today is to say
    that these orders should be vacated.
    THE COURT: Yes. But until and unless they are, you are, I hope, agreeing they
    bind you?
    MS. EFROS: Until they are vacated, we are not consciously ignoring any Court
    order.
    THE COURT: Well, that’s not much of a consolation. All you are saying is you
    are not intentionally committing contempt of Court.
    (12/17/09 Tr. at 20-21.)
    70
    which could not have been anticipated at the time the [decree] was entered into” – and (4)
    “circumstances were . . .
    unforeseen and, hence, despite a good faith effort, the City has not satisfied the goals” in the
    decree. Id. at *13-*14. The court therefore concluded that “[t]he evidence demonstrates that it
    was not the City’s lack of effort, but rather circumstances beyond its control, that resulted in it
    falling short of satisfying the goals in the [decree].” Id. at *16. Not only was Cleveland Fire
    Fighters in a different procedural posture because movants were seeking to extend a decree past
    an already established termination date, but unlike Cleveland Fire Fighters, the record before the
    Court does not support a finding that defendants have “extended [their] best efforts” to satisfy
    the obligations in the consent orders or that there are “circumstances beyond its control” that
    have caused it to fall short.42 To the contrary, defendants freely admit that they are determined to
    seek vacatur and not compliance.43
    42
    While defendants refer to the obligations imposed on the District as having become ever
    more “exacting and onerous” (Defs.’ Mot. to Vacate at 2), it is unclear whether defendants argue
    that any circumstance or obstacle makes the decree “unworkable” or “substantially more
    onerous.” Rufo, 
    502 U.S. at 384
    ; see also NLRB v. Harris Teeter Supermarkets, 
    215 F.3d 32
    , 36
    (D.C. Cir. 2000) (“Compliance over an extended period of time is not in and of itself sufficient
    to warrant relief. . . . [P]arties who have successfully sought modification have also established
    events or changed circumstances which ‘make compliance with the decree substantially more
    onerous,’ make the decree ‘unworkable because of unforeseen obstacles,’ or make ‘enforcement
    [of the decree] detrimental to the public interest.’”). But of course, Rufo teaches that “[i]nternal
    compliance mechanisms instituted to effectuate the decree . . . and hurdles inherent in a consent
    decree’s entry do not count as ‘obstacles.’” Harris Teeter Supermarkets, 
    215 F.3d at
    35-36
    (citing Rufo, 
    502 U.S. at 391
    ). Moreover, other than a reference to the District’s financial
    situation (see infra note 43), defendants, as in LaShawn, 
    2010 WL 1270202
    , at *14, provide no
    substance to their conclusory claim that the consent decrees and 2001 Plan should be viewed as
    “exacting and onerous.”
    43
    Defendants also argue in passing that the Court must take account of the District’s dire
    economic climate and budget shortfall of $583.5 million. (Defs.’ Mem. at 54.) But defendants
    do not complain about the costs of providing services to the class members, but rather they want
    71
    Indeed, what the courts did in these cases is similar to the analysis courts engaged in
    before Horne, which was, in considering whether the objects of a consent decree had been met,
    to look to whether defendants had in good faith complied with the decree. For example, in
    Board of Education v. Dowell, 
    498 U.S. 237
     (1991), the Supreme Court remanded with
    instructions to the district court to decide “whether the [defendant] had complied in good faith
    with the desegregation decree since it was entered, and whether the vestiges of past
    to be relieved of the costs associated with the Special Masters, the Court Monitor, the Quality
    Trust, and the attorneys’ fees incurred in litigating this case. (Id. at 55.) While “[f]inancial
    constraints may not be used to justify the creation or perpetuation of constitutional violations, . .
    . they are a legitimate concern of government defendants in institutional reform litigation and
    therefore are appropriately considered in tailoring a consent decree modification.” Rufo, 
    502 U.S. at 592-93
    . However, in this case, as in LaShawn, 
    2010 WL 1270202
    , at *14, defendants
    have failed to demonstrate that financial circumstances warrant modification.
    Most importantly, the District’s lengthy history of intransigence and noncompliance have
    been the major factors in the increased need for monitoring, reliance on Special Masters, and the
    large costs and fees incurred by plaintiffs and their counsel. Second, the funding of the Quality
    Trust has almost been completed and is arguably not within the Court’s power to modify; the
    responsibilities of the Special Masters have declined; and the Monitor returned over $180,000 of
    her budget in an effort to reduce costs. (12/17/09 Tr. at 115.) Third, this litigation has actually
    resulted in cost savings for the District, since as a result of the efforts of the Court, the plaintiffs,
    and the Special Masters, many class members and DDA customers have been put on the waiver,
    thereby shifting costs from the District to the federal government. (Id. at 27-28.) This effort,
    while now reaching fruition (see supra pp. 57-58), was started long before this administration
    and thus can hardly be credited only to the efforts of the current leadership. Fourth, as Judge
    Hogan held, the costs of monitoring are not properly considered to be obstacles. LaShawn, 
    2010 WL 1270202
    , at *14 (citing Agostini, 
    521 U.S. at 216
     (holding that anticipated costs of
    compliance with an injunctive order are not changed circumstances under Rufo)). Fifth,
    defendants do not address the impact from the three-year multi-million dollar grant the District
    received from CMS in July 2008 via its “Money Follows the Person Rebalancing Demonstration
    Program” (Defs.’ Mem. at 27) or the “Medicaid Infrastructure Grant,” that was “awarded to
    DHCF by CMS to improve the DDA’s day and vocational service system.” (Defs.’ Mem. re
    Alternate Remedy at 7.) Finally, if financial concerns are truly a problem, it is incumbent on the
    District to propose a specific modification for addressing the shortfall, as opposed to advocating
    for wholesale dismissal of the case so that the District can escape future court supervision and
    independent monitoring.
    72
    discrimination had been eliminated to the extent practicable.” 
    Id. at 249-50
    . Similarly, in
    Labor/Community Strategy Center v. Los Angeles County Metropolitan Transportation
    Authority, 
    564 F.3d 1115
     (9th Cir. 2009), the court affirmed the district court’s decision not to
    extend a consent decree addressing the day-to-day operations of the Los Angeles County bus
    system because “the evidence presented supported the district court’s finding that the
    imperfections with respect to load factor targets were de minimis in relation to the overall
    scheme of things.” 
    Id. at 1123
    . And, in McDonald v. Bowersox, No. 89-1086 C(2), 
    1995 WL 17013058
     (E.D. Mo. Sep 18, 1995), aff’d, McDonald v. Carnahan, 
    109 F.3d 1319
    , 1321-22 (8th
    Cir. 1997), the district court dissolved a consent decree regulating day-to-day life on death row,
    describing the critical question as whether “the underlying constitutional rights addressed
    through the decree are ensured through defendants’ compliance with the decree’s provisions in
    good faith for a reasonable period of time.” Id. at *3.
    In none of these cases is there support for defendants’ novel proposition that they can
    attain the objects of the consent orders without complying with their terms as long as they meet
    some ill-defined “constitutional minimum.” See LaShawn, 
    2010 WL 1270202
    , at *20-*21;
    Johnson v. Sheldon, No. 8:87-CV-369, 
    2009 WL 3231226
    , at *7 (M.D. Fla. Sept. 30, 2009)
    (declining to vacate a consent decree despite defendant’s “substantial compliance” and
    “sweeping modifications and improvements to the community mental health system” where
    decree specified exit criteria, which defendant had not yet fully satisfied); R.C. v. Walley, 
    475 F. Supp. 2d 1118
    , 1123 (M.D. Ala. 2007) (“termination of consent decree is not appropriate unless
    the decree’s purposes have been fully achieved”) (citation and internal quotation marks omitted).
    Nor does Horne support this proposition.
    73
    Unlike Horne, this case involves a thirty-year series of consent orders whereby the
    District committed itself to take certain actions to remedy the violations of plaintiffs’
    constitutional rights. These consent orders are what gives content to otherwise vague rights and
    substance to a remedy when those rights are violated.44 Moreover, as the Supreme Court has
    recognized, consent decrees are a valuable tool for resolving litigation – with benefits to
    plaintiffs, defendants and the courts. But if the Court were to permit defendants to walk away
    from their obligations under the consent orders simply because there is a new administration that
    believes that all it needs to do is achieve the constitutional floor (whatever that means), that
    would mean that there would be no future consent decrees involving governmental entities.
    Plaintiffs would have no incentive to enter into consent decrees if the next administration could
    attack a prior administration’s agreement by saying it promised more than was required. And,
    courts would be unlikely to approve a consent decree if each new administration could force a
    retrial based on a claim that the constitutional floor has now been met. While Horne may have
    provided parameters for court involvement in institutional reform litigation and consent decrees,
    it did not declare their demise. In light of the continued vitality of Rufo and Frew, and as long as
    the obligations voluntarily assumed by defendants flow from constitutional violations, this Court
    may not rewrite the existing consent orders so as to reduce defendants’ promise to some ill-
    defined constitutional floor. See Rufo, 
    502 U.S. at 391
    ; LaShawn, 
    2010 WL 1270202
    , at *21.
    Accordingly, as defendants concede they are not in compliance with the court orders, they have
    not satisfied Horne’s first requirement of showing that the object of the consent orders has been
    44
    (See Pls.’ Opp’n, Ex. 27 (charting flow of orders, starting with the rights recognized in
    the 1978 Consent Order and then identifying the remedial actions defendants were ordered to
    take to remedy the violations of those rights).)
    74
    attained.
    B.      Defendants Have Not Yet Implemented a “Durable Remedy”
    Nor have defendants satisfied Horne’s second requirement of showing that a “durable
    remedy” has been implemented. 129 S. Ct. at 2595. What it means to have a “durable remedy”
    is a question that Horne does not answer, but at a minimum, a “durable” remedy means a remedy
    that gives the Court confidence that defendants will not resume their violations of plaintiffs’
    constitutional rights once judicial oversight ends. See LaShawn, 
    2010 WL 1270202
    , at *21;
    Harvey, 
    2009 WL 5792159
    , at *11 (suggesting that a “durable remedy” is the equivalent of
    having in place “a mechanism for future compliance”). Whether there is a durable remedy thus
    necessarily depends on the actual impacts or outcomes experienced by the plaintiffs. The Court
    has to be persuaded that defendants are no longer violating plaintiffs’ constitutional rights and
    that they will “not return to [their] former ways.” Dowell, 
    498 U.S. at 247-48
    . As was the case
    in LaShawn, 
    2010 WL 1270202
    , at *22, defendants ask the Court to conclude that it has a
    durable remedy in place because it has implemented permanent structural changes and will
    remain subject to extensive monitoring even without judicial involvement.
    1.      Permanent Structural Changes
    Defendants focus on the following permanent structural changes: (1) the establishment
    of the Department on Disability Services (“DDS”) as a cabinet-level department with
    independent personnel and procurement authority;45 (2) the creation of the Department of Health
    45
    Defendants also refer to the fact that “the District has recruited high-quality and
    dedicated leadership for the new agency” (Defs.’ Mem. at 38), which is clearly an important
    development in this case given the often inadequate and transitory nature of management over
    the last 30 years. However, as defense counsel conceded during argument, a “durable” remedy
    cannot depend on the retention of particular personnel. (12/17/09 Tr. at 29 (“I don’t think it does
    75
    Care Finance (“DHCF”) as an independent, cabinet-level agency that functions as the single-
    state Medicaid agency with two (to increase to four) staff dedicated to persons with
    developmental disabilities; (3) increased interagency cooperation between DDS/DDA and
    DHCF, including routine weekly telephone calls, staff co-location and extensive collaboration on
    a number of ongoing projects; (4) increased interagency collaboration between DDS/DDA and
    the Health Regulation and Licensing Administration (“HRLA”), including sharing findings and
    conducting joint investigations; and (5) the establishment in July 2009 of a Task Force including
    representatives from DDS/DDA, DHCF, and HRLA to advise the Mayor regarding all services
    for individuals with developmental disabilities. (Defs.’ Mem. at 37-43.)
    These structural changes are all extremely positive developments, but they do not
    necessarily translate into proof of a durable remedy.46 All of the changes have occurred within
    the past year or two, and, especially in view of the fact that this litigation has spanned over 30
    years and still defendants achieved compliance, it is simply too soon to tell whether they will
    result in improved outcomes for the plaintiffs, and, if so, whether the improvements will be
    sustained absent judicial involvement. Even defendants admit that systemic change can take
    three to five years.47 (Defs.’ Mem.’ at 70; Defs.’ Mem., Ex. 16, Expert Report of Nancy Thaler,
    depend on Ms. Nuss staying, although we certainly want Ms. Nuss to stay”).) Indeed,
    defendants’ recent filing suggests that if the Court imposes the remedy recommended in the 2009
    Special Masters’ Report, Ms. Nuss will decline to remain in her job. (See Defs.’ Mem. re
    Alternate Remedy at 3-8.)
    46
    Similar arguments were raised by the District and rejected by LaShawn, 
    2010 WL 1270202
    , at *13-*14 and by the D.C. Circuit in Harris Teeter, 
    215 F.3d at 36
    , where the Court
    refused to terminate a consent decree even though defendant had instituted personnel changes
    and an internal reorganization.
    47
    Even in their latest filing, defendants acknowledges that there are
    76
    July 14, 2008 (“In no state have problems been solved over night. The full transformation of a
    system – the building of structure and processes and the appointment of strong leaders to manage
    the way it all works together – takes several years. Three to five years is the standard time frame
    assumed to be necessary to turn a system around. Progress, that is evidence of the effort to
    change things, becomes evident only over time.”); see also 12/11/08 Trial Tr. at 353 (Test. of
    Laura Nuss) (“you don’t see the outcomes that you want to see as fast as you would like to see
    them. You know, this is a historically plagued service system. So I think it is taking time to see
    the outcomes. But, you know, we still see the bad outcomes for individual issues. But we’re also
    seeing a lot of positive ones”).
    Moreover, with respect to interagency coordination and collaboration, there have been
    improvements, but the District’s performance has been less than consistent given the problems in
    this area as recently as December 2008. (See 2009 Special Masters’ Report at 129 (“Time has
    shown that the problems with interagency coordination persist under the Fenty Administration as
    they had under the previous administration, and have resulted in the same sub-standard
    conditions, lack of necessary medical care, as well as inappropriate and ineffective day
    programs.”).) For example, defendants’ expert, Nancy Thaler, concluded that it was a failure in
    interagency communication that caused “[t]he recent decision made by MAA to change the
    remaining systemic weaknesses specific to the District’s IDD system: access to
    high-quality behavioral health services; clinical services, including physical
    therapy (PT), occupational therapy (OT), speech therapy (SPL), and nutrition
    services; and transformation of the legacy facility-based day services to
    person-centered habilitation and vocational-preparation programs that provide
    quality habilitative, vocational and community-integrated services appropriate to
    each consumer’s needs and preferences.
    (Defs.’ Mem. re Alternate Remedy at 11-12.)
    77
    Medical Assistance transportation arrangements [to have] a negative impact on the consumers in
    the DDA program by limiting their capacity to travel to medical and other appointments.”
    (Defs.’ Mem., Ex. 16, Addendum to Expert Report of Nancy Thaler at 11-12, Oct. 7, 2008.)
    Similarly, as of December 2008, there continued to be problems with obtaining guardianships in
    a timely fashion. (2009 Special Masters’ Report at 45, 49 (“The delays in obtaining
    guardianship for the provision of informed consent for medical and dental treatment of class
    members . . . have continued in the compliance period,” leading to defendants continued inability
    “to provide class members with medical treatment and health care that is timely, particularly for
    class members who have acute medical needs.”).)
    2.     Monitoring
    The second part of defendants’ durable remedy argument is their claim that their
    performance is subject to extensive monitoring, including monitoring by the Superior Court, the
    Center for Medicare and Medicaid Services (“CMS”), the Quality Trust, and the District’s
    internal monitoring by the Health Regulation and Licensing Administration (“HRLA”) and the
    four units of DDA’s Quality Management Division – Health and Wellness, Quality Enhancement
    and Quality Improvement, Incident Management and Enforcement, and Mortality Review.
    Unfortunately, there are a number of problems with defendants’ contention that this monitoring
    is proof of a durable remedy.
    i. Superior Court – As described by defendants, the Superior Court for the
    District of Columbia plays a significant role in overseeing plaintiffs.48 However, the Superior
    48
    According to defendants,
    any person brought before the Court (to be admitted or committed to DDS/DDA)
    78
    Court’s authority is limited to treatment decisions about individual class members, and although
    this system has been in place since 1979,49 significant systemic reforms have not been achieved.
    Moreover, proposed legislation may signification alter the role of the Superior Court. See D.C.
    Council, B18-0501, Developmental Disabilities Reform Act of 2009 (introduced Oct. 20, 2009).
    Thus, although Superior Court reviews individual cases and does play an important role, its job
    is limited and in light of the pending legislation, the Court can hardly count on its continued
    involvement.
    ii. CMS – According to defendants, CMS, the federal agency that administers the
    Medicare and Medicaid programs, “already provides extensive oversight for services provided
    by DDS/DDA.” (Defs.’ Mem. at 44.) For example, the District must submit an annual report to
    CMS that addresses both fiscal and quality performance measures, and CMS conducts
    “unannounced random audits on various areas of its six assurances, including level of care,
    service plan, qualified providers, health and welfare, administrative oversight, and financial
    accountability.” (Id. (citing Nuss. Decl. ¶ 4, Oct. 7, 2009) (Ex. 4 to Defs.’ Mem.).) In addition,
    has a right to be represented by retained or appointed counsel. See SCR-MRP 11;
    see also D.C OFFICIAL CODE § 7-1304.12(2) (authorizing fees to be a paid to
    appointed counsel). Moreover, any interested party has the right to initiate an
    action in Superior Court to compel DDS to accord persons with IDD the rights
    afforded them under District law. D.C OFFICIAL CODE § 7-1305.13(a).
    Indeed, each person committed to DDS/DDA supervision is entitled to an annual
    judicial hearing to determine whether the person has “benefitted from . . .
    habilitation.” Id. at § 1304.11(a)(1). These procedures conclusively demonstrate
    that members of the Evans class have an adequate remedy at law for any potential
    future failure by the District to provide them with appropriate treatment.
    (Defs.’ Mem. at 43-44.)
    49
    See The Mentally Retarded Citizens Constitutional Rights and Dignity Act of 1978,
    effective March 3, 1979 (D.C. Law 2-137; D.C. Official Code § 7-1301.02 33 et seq.).
    79
    according to defendants, “CMS will be initiating expanded . . . quality-reporting in the next
    fiscal year that mirrors the expanded quality management requirements now found in the HCBS
    waiver program.” (Id.) Finally, defendants assert that:
    From February 2007 to March 2009, CMS engaged in even more intensive
    monitoring to ensure the then-MAA and DDS/DDA’s compliance with the federal
    HCBS waiver requirements. This included monthly written and telephonic
    monitoring of a corrective action plan in three of the six assurances: Plan of Care;
    Health and Welfare; and Administrative Oversight. In March 2009, however,
    CMS determined that the District had “made major changes in the performance,
    structure, oversight mechanism, and systems sufficient enough to engage in
    continuous Quality Improvement (QI).” To qualify for such a finding, a state
    must demonstrate a robust system of “discovery, remediation and improvement”
    in all six assurances. Citing the “demonstrated effectiveness of the many newly
    implemented systems to meet the CMS quality requirements,” CMS discontinued
    its intensified monitoring.
    (Defs.’ Mem. at 45 (quoting and citing CMS Letter, March 9, 2009 (Ex. 19 to Defs.’ Mem.).)50
    Plaintiff responds that the CMS monitoring “is irrelevant . . . [because] CMS monitors all states
    that participate in the federal Medicaid program. All such states are required to file the type of
    annual reports that the defendants reference.” (Pls.’ Opp’n at 82.) But more importantly, CMS
    does not perform regular on-site audits to determine the quality of care provided to class
    members and other DDA consumers. According to the DOJ counsel who represents plaintiff-
    intervenors, the District conducts the on-site reviews of community placements and the regional
    office of CMS, “as part of their quality review that occurs every five years, . . . requests evidence
    from the District that it is meeting all the statutory and regulatory assurances required for CMS.”
    (12/18/09 Tr. at 195.) Given CMS’ limited role in conducting on-site visits so that it can assess
    50
    Of course, prior to CMS issuing its Letter of March 9, 2009, the District had been put
    on a “corrective action plan” – a program of intensified monitoring – due to the fact that the
    District failed to substantially meet three of the six waiver assurances. (Defs. Mem., Ex. 19; see
    also Court Monitor Rep. at 27, Jan. 26, 2007.)
    80
    the impact of the systems on class members, the Court can take little solace from the increased
    role of CMS, which is a recent development that will not begin until sometime this year and will
    be a far cry from the type of monitoring that has any direct impact on the day-to-day lives of the
    plaintiffs.
    iii. Quality Trust – As part of the 2001 Plan and as part of the settlement of the
    Evans litigation, the Quality Trust was established in 2001 as an quasi-independent entity tasked
    with providing “monitoring, legal services and lay advocacy services for consumers in the
    District of Columbia.” (2001 Plan at 45 (footnote omitted).) As part of its function, the Quality
    Trust was to monitor services being provided to the over 1400 non-class members and would
    eventually take over from the Court Monitor the job of monitoring the Evans class members.
    (Id. at 46; see also supra pp. 13-15.) Specifically, the Quality Trust is tasked with developing
    and implementing an annual monitoring plan with input from all stakeholders; reviewing all
    reports and investigations of serious incidents involving DDS consumers; issuing annual reports;
    and reviewing and providing input regarding DDS budgeting information. (2001 Plan at 47-48.)
    However, although defendants point to the Quality Trust as an important monitoring component,
    the Quality Trust has informed the Court in its most recent filing that the “proposal to transition
    the monitoring function solely to Quality Trust is premature.” (Quality Trust Opp’n at 21; see
    also id. at 27 (“When adequate structures are in place, and an opportunity for meaningful
    transition from the Court Monitor has occurred, Quality Trust will be able to assume
    post-litigation monitoring of the Evans class members along with its current monitoring
    function.”).) The Quality Trust estimates that it will take 12-18 months “to have a meaningful
    transition.” (12/17/09 Tr. at 140.) Given this assessment, the Court cannot yet look to the
    81
    Quality Trust to support defendants’ durable remedy argument.51
    iv. Internal DDS Quality Assurance System – According to defendants,
    “internal monitoring methods will ensure that it sustains the extensive reforms now in place.”
    (Defs.’ Mem. at 48). Within the Developmental Disabilities Administration, the Quality
    Management Division (“QMD”) “monitors all aspects of the service-delivery system to ensure
    compliance with federal and local law, national best practices, and applicable court orders.” (Id.
    (quoting 10/7/09 Nuss Decl. ¶ 51).) The QMD is divided into four functional units: Health and
    Wellness, Quality Enhancement and Quality Improvement (“QE/QI”), Incident Management and
    Enforcement (“IMEU”), and Mortality Review. (Defs.’ Mem. at 48-50 (quoting 10/7/09 Nuss
    Decl. ¶ 52).)
    While improvements in internal monitoring are critical to the existence of a durable
    remedy, over the lengthy history of this case, defendants’ monitoring has been woefully
    inadequate both in terms of the quality and speed of internal investigations of both deaths and
    serious incidents involving class members and DDA consumers. This problem has continued
    through 2009. (See, e.g., Quarterly Report of the Court Monitor at 7, December 10, 2009;
    Quality Trust for Individuals with Disabilities Monitoring Unit Annual Report and Data
    Summary at 1, Oct. 1, 2008 – Sept. 30, 2009 (concluding that “progress in improving the
    systems and supports for people with developmental disabilities in the District of Columbia is
    51
    The District’s proposed alternate remedy, set forth in a motion filed just days ago (see
    supra note 2), the Quality Trust’s responsibility for on-the-ground monitoring appears to have
    shrunk and it is now described as an “active[] members of oversight committees that review
    findings generated by these systems and initiatives and contribute to recommendations for
    improvements going forward.” (Defs.’ Mem. re Alternate Remedy at 13.) Obviously, if its
    remedy were to be adopted, the Quality Trust’s role (despite the District’s obligation to fund it
    with over $30 million) would be reduced to “ad hoc monitoring.” (Id., Ex. A at 7.)
    82
    mixed. . . . A more consistent and transparent process for investigating Serious Reportable
    Incidents at DA is also necessary . . . . Our data indicates that investigation reports are not being
    completed consistent with policy.)
    The flaws in the District’s internal monitoring also became apparent recently when the
    District had to put into receivership one of its largest providers, Individual Development, Inc.
    (“IDI”). While the District touts this action as an example of “[t]he new institutional culture and
    collaborative ethos” of officials from DDA, DHCF, and HRLA (Defs.’ Mem. re Alternate
    Remedy at 5), what it conveniently fails to disclose is that many of the problems with this
    provider that led to the receivership were uncovered by the Court Monitor and reported by the
    Court Monitor and the plaintiffs, not by the District’s internal monitoring apparatus. (See
    12/18/09 Tr. at 239.)
    In sum, defendants have not demonstrated a durable remedy as required by Horne.
    While it is true that the District has made significant strides in the last year or two under new
    leadership, the Court does not have confidence that the agency’s progress is durable and self-
    sustaining. Accord LaShawn, 
    2010 WL 1270202
    , at *21-*22. As documented by the 2009
    Special Masters’ Report, the three most recent Court Monitor Reports and the 2009 Quality
    Trust’s Monitoring Unit Annual Report and Data Summary, results are, at best, uneven, and it is
    far too soon to determine whether the structural changes, some of which are still in the
    implementation phase, will have the desired impacts on the safety, health and welfare of the class
    members.
    CONCLUSION
    In 1978, the parties agreed, and the Court endorsed that agreement in an Order and
    Judgment, that plaintiffs had certain constitutional rights, that those rights had been violated, and
    83
    that to remedy those violations, defendants would have to take certain remedial actions. More
    than 30 years later, defendants ask the Court to relieve them of those obligations under Rule
    60(b)(5) on the grounds that enforcing those promises prospectively is no longer equitable.
    While defendants certainly have the right to file a 60(b)(5) motion, they have the burden to
    justify their motion. Defendants have failed: the objectives of the original consent decree and
    subsequent court orders, as incorporated in the 2001 Plan, have not been achieved and
    defendants have not demonstrated that the prospective enforcement of the court orders would be
    inequitable or “detrimental to the public interest.” Horne, 129 S. Ct. at 2593. Accordingly,
    defendants’ motion for vacatur and dismissal will be DENIED.
    /s/
    ELLEN SEGAL HUVELLE
    United States District Judge
    Date: April 7, 2010.
    84
    

Document Info

Docket Number: Civil Action No. 1976-0293

Judges: Judge Ellen S. Huvelle

Filed Date: 4/7/2010

Precedential Status: Precedential

Modified Date: 10/30/2014

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